What Tests Should I Expect During a Lung Transplant Evaluation?

Once you have been accepted into the evaluation process, you will be scheduled for tests ranging from physical therapy assessment to heart catheterization. Each test is important and must be passed. Medical tests can make you anxious, even when they are routine.  Of course tests that have so much riding on them can cause a great deal of stress.  Sometimes just knowing what to expect can help calm some of those fears.

Here are some of the tests that you may be required to pass:

• Pulmonary Function Tests: You are most likely familiar with these tests. Typically you will be asked to breathe in and breathe out completely to get a measurement of the amount of air your lungs can hold and the strength with which you are able to breathe.
• Blood Tests:  You will be checked for infections or viruses that could cause problems after the surgery.  Your kidney, liver and immune system functions will be tested, and your blood type will be identified.  Let’s just say that there will be more than one vial of blood drawn.
• Arterial Blood Gas:  If you have been hospitalized for severe COPD, you likely have had one of these tests.  The blood draw comes from an artery as opposed to a vein, and it will provide details about the oxygen and carbon dioxide in the blood that cannot be accurately obtained from a normal blood draw.
• Chest CT Scan:  This will provide the team with a three-dimensional image of the inside of your chest.  For a CT scan, you will need to remain very still as you are moved through a round machine.
• Ventilation-perfusion Lung Scan:  This test will record data about the blood supply and air flow in your lungs.  You will breathe through a mask after having an injection into a vein in your arm.
• Heart Catheterization:  A catheter will be inserted into a large blood vessel and thread into your heart.  A special dye will be injected through the catheter to allow the doctors to see your blood vessels and measure the pressures inside your heart.  Don’t worry, the area where the catheter is inserted will be numbed, and you may be given medication to help keep you relaxed during the procedure.
• Esophageal Manometry:  This test will allow the doctors to see how the muscles in your esophagus are working.  You will have a tube inserted down your nose, and you will be asked to drink water.
• 24-hour Gastric pH Test:  Typically this test will occur after the esophageal manometry.  It will show how often acid comes up into your esophagus from your stomach.  You will have a tube inserted into your stomach through your nose which will remain there overnight.  You will be instructed to eat and drink normally, keeping a record of what you eat and drink during the test.  The tube will be removed the following morning.
• Pulmonary Physical Therapy Assessment:  This test will give the team an understanding of your tolerance for physical activity.  You will be required to walk for six minutes without stopping.  During the test, you may use your oxygen higher than you would at rest, if needed.  You may also be required to pass other physical requirements as well, depending on your transplant center.

The above list is by no means the full list of tests that you may need to go through.  Other tests could be given depending on each individual case.  For example, my mom had a stroke when I was fourteen years old, so they performed an MRI to determine if there were any remaining issues that would keep her from being a good candidate for transplant.  She also had several major surgeries when I was a child, and because of that, she had a few other tests that would not normally be given.  Just know that the transplant center needs the information gained from these tests to determine if you will make a good transplant candidate.  They will be thorough, and as each test is explained to you, I’m sure you will gain a deeper understanding of why they take such care to make sure that you will be able to handle the transplant.