Starting the Lung Transplant Process

You may be a candidate for lung transplantation if you have end-stage lung disease -- when your lungs are so unhealthy that they cannot function, and your lung disease cannot be corrected any other way. The following lung diseases may cause your lungs to fail:

• Pulmonary fibrosis
• Chronic obstructive pulmonary disease (COPD)
• Cystic fibrosis
• Pulmonary hypertension
• Scleroderma 
• Sarcoidosis
• Alpha-1 antitrypsin deficiency
• Occupational lung disease
• Lung disease due to prior cancer treatments, such as bone marrow transplant, radiation, and chemotherapy

Referral from a Doctor
Typically, your pulmonologist will refer you to our team. You can also ask them to complete a referral form. Your doctor will submit the form with your medical history, including recent lab and medical test results. 

Contact Our Team to Self-Refer
You can also start the process with our team without a doctor’s referral. Call 919-613-7777 to learn how to begin the review process. You will need your insurance information, recent medical records, and imaging and other test results to get started.

The Medical Review
After we receive a referral and the required documents, our lung transplant referral coordinator will gather any additional information needed to begin the review process. This will include financial approval from your insurance company. The review will take place before we meet with you. Our lung transplant team will carefully examine your records to determine if you are a candidate for lung transplant surgery and to assess the severity of your lung disease. They will also identify any health concerns that need to be addressed before you can be considered for a lung transplant. Your doctor will notify you about the results of the review and next steps.

If the results of your review indicate that lung transplant surgery may be appropriate for you, our transplant coordinator will contact you to set up your first appointment with a Duke transplant pulmonologist for a lung transplant evaluation. This can take place in person or through video visits.

We may recommend a complete, five-day in-person evaluation or a two-day limited evaluation. The limited evaluation is for people with less advanced lung disease. It can take place in person or via a video visit. Complete evaluations are reserved/required for people with advanced lung disease who are ready for surgery. 

Many people come to Duke from outside of North Carolina for lung transplant surgery. To ease the burden and expense of travel, we offer several options for remote care. Telehealth appointments are currently available and covered by insurance in more than 20 states -- with more to follow -- for people who may be candidates for lung translation but do not need surgery immediately. If your condition worsens, you will come to Duke for a complete in-person evaluation. 

Before your first remote evaluation session, you will undergo testing -- including blood, breathing, and imaging tests -- at a facility close to you. During your video-based appointment, you will meet your transplant pulmonologist and learn more about the lung transplant program at Duke. You and your pulmonologist will also discuss your test results and any health concerns that need to be addressed before surgery. 

Video Check-In Appointments Before and After Surgery
If you have questions or concerns after your limited evaluation, you can schedule additional video visits with your transplant pulmonologist. Telehealth appointments are also available after lung transplantation.

Consultations
In some cases, we offer consultations, which can take place in person or remotely. These appointments are for people who have already completed a comprehensive evaluation elsewhere and want to be listed at more than one center or by special request from an insurance provider. 

Remote, Written Second Opinion Reports
You can get a written second opinion report from a Duke transplant pulmonologist. A second opinion can confirm a diagnosis, offer a different diagnosis, provide information about the most advanced treatments available, and ensure confidence in your decisions when faced with a serious medical condition.
 

Step 2: Evaluation