Transplant Process

Referral

Upon referral from a primary care physician, the Transplant Coordinator presents the information to the Transplant team for review. The Transplant Coordinator collects the medical history, physical examination results, radiology studies, lab work, and requests other needed information from the referring physician. After the transplant office obtains insurance authorization, a transplant evaluation is scheduled with a multidisciplinary team.

Evaluation

The transplant evaluation can be conducted on an outpatient or inpatient basis, and typically requires 1 to 4 days in Birmingham. The evaluation includes diagnostic testing, consultations by Cardiology, Nephrology, Hepatology, or any subspecialty relevant to the care. The multidisciplinary team evaluates the patient and provides education throughout the evaluation. This team includes a pharmacist, a nutritionist, a child life therapist, a social worker, a psychologist, physical therapist, counselor and the transplant coordinator. The patient is presented to the multidisciplinary team for consideration of transplant when all aspects of the evaluation are completed.

Pre-Transplant

After the evaluation, if the best option for care is transplantation, the Transplant Coordinators will list the patient with the United Network for Organ Sharing (UNOS) national donor search list. The transplant team will obtain authorization for the transplant procedure from the insurance company. The patient’s listing status with UNOS is based on his/her current medical condition and lab tests. During the waiting period, the Transplant Coordinator will be in close communication with the referring physician to keep him/her informed about the patient’s condition.

Transplant

When an organ becomes available, the Transplant Coordinator contacts the family and requests that they come to the hospital. The patient is admitted to the Transplant Unit and is prepared for surgery. During the surgery, the family will be updated about the patient’s condition and the progress of the procedure. Immediately after surgery, the patient is admitted to the Intensive Care Unit (ICU). The length of time spent in the ICU varies based on each child’s needs. Once the patient is stable, he/she will be transferred to the Transplant Unit.

Post-Transplant and Follow-up Care

The organ recipient and family will be educated on transplant maintenance and care including: medications, nutrition, scheduled lab work, clinic visits, activity level, returning to school, immunizations, and dental care, as well as individual specific instructions.

At a typical follow-up clinic visit, the doctor and the nurse will discuss the patient’s current health, check the patient’s weight and blood pressure, and perform a physical examination. Tests and blood work will be ordered at each appointment to evaluate the organ’s function, to observe for signs of rejection, and to monitor the effectiveness and level of the immunosuppressant medications.

Throughout the transplant process, the referring physician will be regularly updated on the patient’s progress by the transplant team. When the patient is discharged, the transplant coordinator will send the referring physician a packet of information outlining a treatment regimen, including medical records, current medications, and the recommended laboratory schedule. Transplant team will continue to keep the referring physician aware of any changes to immunosuppressant medications and annual evaluations.