Comprehensive Workup

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Inova Lung Services — Programs and Services — Lung Transplant — The Transplant Process: Comprehensive Workup

Comprehensive Workup

Comprehensive WorkupDuring a comprehensive work-up, you will be seen and evaluated by a transplant pulmonologist. Towards the completion of your transplant testing, you will have a lung transplant education day where you will meet the transplant surgeon, social worker, post lung transplant nurse practitioner, financial coordinator, nutritionist, pharmacist, and pulmonary rehabilitation expert. Additional consultations (i.e. psychiatrist, cardiology, nephrology, infectious diseases, etc.) are obtained as necessary.

Many of the following studies are obtained in potential lung transplant candidates. Please note, all tests are not a prerequisite for referral. You will be informed which tests are required.

Pulmonary

  • Pulmonary function tests (PFTs). Includes spirometry, lung volumes, diffusing capacity, arterial blood gas and others as needed
  • 6-minute walk test
  • Chest X-ray (CXR) at Inova Fairfax Hospital
  • CT scan of the chest at Inova Fairfax Hospital
  • Ventilation/perfusion (V/Q scan with quantitative perfusion). This study may be omitted in patients requiring bilateral transplants.
  • Bronchoscopy (in select cases)

Cardiac

  • EKG
  • Echocardiogram
  • Right and left heart catheterizations

Infectious disease

  • PPD
  • Serologies for CMV IgG and IgM, VZV Ig and IgM, EBV IgG and IgM, HTLV, RPR, measles, HIV, HepB Sag, HepB AB, Hep C AB
  • Toxoplasmosis titers for heart-lung recipients only
  • Vaccinations
    • Pneumovax (if not previously received)
    • Prevnar 13 (if not previously received)
    • Annual influenza vaccine
    • Hepatitis B if not immune
    • Shingles (Shingrix)
    • HPV (<26 years old)
    • Tetanus every 10 years
    • Sputum culture and sensitivity test, fungi, and AFB in bronchiectasis and cystic fibrosis patients

Miscellaneous tests

  • Blood type – checked twice
  • 24 hour creatinine clearance, urinalysis
  • PAP smear, mammograms in all females once a year
  • Duplex scan to r/o DVTs
  • Arterial dopplers of lower extremities if there is clinical suspicion of peripheral vascular disease
  • Carotid doppler studies in patients with suspected vascular disease
  • Colonoscopy for patients over age 40 or Cystic Fibrosis
  • Esophagogastroduodenoscopy (EGD)
  • Right Upper Quadrant Ultrasound/Liver Ultrasound
  • Barium Swallow Study
  • Gastric Emptying Study
  • 24 hour pH Probe and Manometry
  • Bone densitometry
  • Dental clearance
  • Dermatology clearance

Laboratories

  • CBC with differential
  • Chemistries
  • PT/PTT
  • Lipid panel as needed (LDL, HDL, cholesterol, and triglycerides)
  • Thyroid function studies
  • Stool for occult blood x 3
  • PSA and testosterone level in all males over age 50
  • Serum immunoglobulins in all patients with bronchiectasis/chronic infections
  • Blood type, panel reactive antibody screen
  • Immune cell function assay
  • Drug toxicity/urine screen