Your lung doctor (pulmonologist) must refer you to our program. We’ll also coordinate with your other providers during your evaluation and long-term care.

Next, we’ll review your medical records and history to identify any concerns that might affect your transplant outcome. If no issues are found, we’ll call you and discuss next steps, including scheduling your first appointment.

At this appointment, a lung transplant doctor will review your health in detail and explain the transplant process, along with risks and benefits.

If a lung transplant is not a good option for you, your doctor will explain why. We'll also talk with your referring provider about the decision and suggest other treatments that may work for you.

If you and our transplant team decide that a lung transplant may be a good option, you’ll move forward to the full evaluation process.

If a lung transplant seems like a good option after your first clinic visit, the next step is a full evaluation. This process includes medical tests and visits with our transplant team to help us decide if a transplant is the right treatment for you.

What to expect

We’ll set up tests to:

• Assess your lung disease
• Check to make sure you do not have any problems with your other organs (like your heart, liver, kidneys, bones or esophagus)

Some tests may be done by your local providers. Others must be completed at UW Medicine.

Who you’ll meet

Your evaluation includes visits with everyone on the Lung Transplant Team, including:

• A lung transplant doctor (transplant pulmonologist) determines whether you are a good candidate for transplant and will provide care for you immediately after the transplant and for the rest of your life after transplant.
• A transplant coordinator provides education about the process and is your advocate throughout.
• A transplant surgeon meets with you to discuss the transplant procedure, risks, possible complications and recovery process.
• A transplant pharmacist will teach you about the medicines you will be taking after your transplant.
• A social worker will evaluate your ability to cope with the stress of having a transplant and identifies your support network.
• A financial counselor will talk to you about associated costs and insurance coverage.
• A psychiatrist may conduct an in-depth psychiatric evaluation.
• A dietitian will assess your diet and provide nutrition education.
• You may also be referred to another service for consultation to check for other medical conditions.

How the evaluation works

• Most appointments and tests are outpatient, so you won’t stay overnight in the hospital.
• We try to group tests together to minimize your travel. If needed, we can also spread them out over more days.

Timeline

• Most evaluations take about a week, but some take longer.
• Your results will help us decide whether a lung transplant is right for you.

Financing a lung transplant

A lung transplant is a significant medical procedure that involves various costs, including:

• Pre-transplant evaluations and testing
• Surgery and hospital stay
• Post-transplant medications (required for life)
• Lifelong follow-up care

You will have an appointment with a transplant financial coordinator (TFC) during your transplant evaluation. The TFC will work with your insurance provider to understand coverage and talk with you about expected costs.

This committee includes all members of the Lung Transplant Team. It includes transplant pulmonologists and surgeons, nurse coordinators, social worker, psychiatrist, nutritionist, financial counselor, pharmacist and other providers as needed. The committee may also review input from your primary providers and other consultants.

After their review, the committee may decide to:

• Accept you as a lung transplant candidate: If you are accepted, we will contact you to discuss the steps needed before you are placed on the waiting list.
• Defer making a decision: Additional visits or medical tests may be needed. After these tests, the committee will meet again to review and make a new decision.
• Not accept you as a lung transplant candidate: In this case we will contact you to explain the reasons for the committee’s decision. We will suggest other available treatment options. You may ask your primary pulmonologist (lung doctor) to refer you to other transplant centers for evaluation.

Once you're accepted as a lung transplant candidate and we receive final approval from your insurance provider, we’ll contact you to confirm you’re ready to be placed on the waiting list.

The United Network for Organ Sharing (UNOS) manages the list and uses the Lung Composite Allocation Score (CAS) to match patients with donor lungs based on urgency and expected outcomes.

Confirming insurance benefits

Before you are placed on the waiting list, we will confirm final approval of your insurance benefits for your lung transplant.

Traveling to and staying in the Seattle area

Transplant surgery can’t be scheduled in advance—you may get the call any day, at any time. When that happens, you must be able to arrive at UW Medical Center – Montlake in a reasonable amount of time.  You must also stay close to the hospital after your transplant surgery.

• If you do not live within driving distance from UW Medical Center – Montlake: You may be required to relocate to the Seattle area or have a flight plan before you can be placed on the waiting list.
• If you do not live within an hour of UW Medical Center – Montlake: You and your caregiver must stay within one hour of the hospital for a minimum of three months after you discharge from the hospital.

A lung transplant social worker can help you explore travel and housing options.

Waiting for a transplant

You may wait a few days or a few years before the right donor organ is found.

The Scientific Registry of Transplant Recipients (SRTR) updates national and program-specific wait time data every six months. You can view UW Medicine’s median wait time for lung transplant at srtr.org.

While on the waitlist:

• Stay in close contact with your medical team: Your pulmonologist and primary care provider will continue to manage your health. You must tell the UW Lung Transplant Team about any changes in your health.
• Attend required follow-up visits at UW Medical Center – Montlake: Most patients are seen every two to three months, but you may need to come more often.

Being removed from the waiting list

You may be removed from the list if your health changes, you lose insurance or caregiver support, or you no longer meet criteria. We’ll talk with you about next steps and other treatment options if that happens.

Getting “The Call”

If donor lungs are a good match, we’ll call you—day or night. You must:

• Answer promptly
• Be ready to travel to UW Medical Center – Montlake right away

Sometimes donor lung(s) that initially seem like a good match may later be found unsuitable. This means they cannot be used for a transplant. If we are not able to use the donor lung(s) for your transplant, the surgery will be canceled, and you will be discharged from the hospital. This is called a “dry run.” Many patients experience at least one before receiving their transplant.

Hospital care after your transplant

You’ll receive care from several expert teams beyond the Lung Transplant team:

• ICU care (Cardiothoracic Intensive Care Unit): Usually three to five days on average
• Acute Care Unit: About 14–20 days, depending on recovery
• You’ll also work with physical therapists, nutritionists, respiratory therapists and others

Caregivers must be present for discharge training the week before you leave the hospital.

Recovery

You’ll need 24/7 caregiver support for at least three months after discharge to help with many daily activities. Most patients can walk, bathe and dress within four to six weeks. Physical therapy or pulmonary rehab may be recommended. You must also limit arm use for 12 weeks to protect your chest as it heals.

Follow-up visits

You will have many follow-up clinic visits after your surgery. The Lung Transplant Team will watch you closely for any signs of problems. Your caregivers must:

• Provide transportation to all follow-up visits as it will not be safe for you to drive for several months after your surgery.
• Attend all follow-up visits with you so they can learn about changes in your medicines and treatments.
• If you do not live within an hour of UW Medical Center – Montlake: You and your caregiver must stay within one hour of the hospital for a minimum of three months after you discharge from the hospital.