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Comprehensive Workup

Comprehensive WorkupDuring a comprehensive work-up, you will be seen and evaluated by a transplant pulmonologist, transplant surgeon, social worker, psychiatrist, financial coordinator and pulmonary rehabilitation expert. Additional consultations (i.e. 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
  • Dobutamine/thallium stress test. This test may be ordered instead of cardiac catheterization.
  • MUGA scans in select cases (e.g., patients with pulmonary hypertension)

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)
    • Annual influenza vaccine
    • Hepatitis B if not immune
    • Varicella if not immune
    • 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 50
  • Bone densitometry for patients with a history of steroid therapy or cystic fibrosis
  • Dental 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

Questionnaires
  • St. George's respiratory questionnaire (quality of life)
  • History of disease questionnaire
  • Transplant education questionnaire (transplant knowledge)