Alpha-1 Advocacy Alliance - Testing Prior to Lung Transplant

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Testing for AAT Deficiency
Simply click HERE Alpha One International Registry
provides AAT Deficiency Testing. This AAT Deficiency Testing is a
COMPLETE CONFIDENCIAL TESTING SERVICE
and WITHOUT COST TO YOU.
This testing will include measuring the CONCENTRATION of AAT in your blood, determining the TYPE of ATT in your blood and (where appropriate) determining your AAT genotype by testing the DNA in your blood; State of the art, full-spectrum Alpha-1 Testing .

Please read the detail at: AAT Deficiency Detection Center

Testing Guide PRIOR to Lung Transplant
You will undergo a tremendous amount of testing to ensure your ability to survive a lung transplant. Below you will find some of the tests that you will be required to undergo. Each center has their own requirements, so the following list should be used as a guideline for what you might expect.

Chest X-ray: This provides the transplant team a picture of your heart and lungs. Measurements of your lungs will be taken from the X-rays and used to determine the size of donor lungs that you would require for transplantation. This will also help determine if you should be considered for a single or double (two) lung transplant.

Bloodwork: These tests help to determine how well your kidneys and liver function as well as how other systems in your body are functioning. Specialized tests to determine exposure to common viruses ( EBV, CMV are the most common tested for )as well as testing to determine blood and tissue type are also performed. These matches will later be matched to the donor lung to ensure the best possible chance of not rejecting the donated lung(s).

EKG: This test provides a tracing of the electrical activity of the heart and will help the doctors determine the health of your heart tissue. Most patients have had this before and know that it is painless.

TB Skin Test: This test is performed to determine if there has been exposure to tuberculosis. This involves a small needle prick to the skin and is generally checked in 48-72 hours at the office.

Pulmonary Function and Exercise Tests: These tests help to determine how much breathing capacity you have as well as the amount of damage that has been done to your lungs by your lung disease. The technicians may also give you some bronchodilators to use to help determine if you have an asthmatic component with your disease. The tests involve breathing in and out and are relatively painless. Some people experience some anxiety with these tests, but a good technician will work with you. If you need additional time in between breaths, tell them! These technicians are used to dealing with people short of breath!

CT Scan: This is a specialized type of computerized X-ray that provides the transplant team with a detailed picture of your lungs. This picture provides information about the extent of damage your lungs have suffered as well as the presence of any nodules that would need further follow-up. This test at most centers involves lying down, though there is a new stand up CT scan just being released on the market. Your doctor may order the scan with contrast which will involve an IV in the arm with contrast solution. This will make you feel warm all over, but does not hurt at all. The whole scan takes about thirty minutes.

Heart Catheterization: A right heart catheterization is performed to measure the blood pressure in the blood vessels around your heart. This will provide information about how well your heart is functioning. A left heart catheterization may also be performed at the same time as the right heart catheterization. For this test, X-rays of your heart are taken after a dye is injected into the arteries that feed the heart muscle. This will allow the doctors to determine if there is any blockage in these arteries. This is generally done under light sedation. Each center will do it a little bit differently and have slightly different directions, so use this as a guideline only. The artery in the leg or the neck may be used as an insertion point for the dye. The point of entry will be chosen by your technician and will be pressed on for an extended period after the procedure. Some centers require the patient to remain still for several hours while others require an overnight stay.

Echocardiogram: This is a series of pictures of your heart that is generated by sound waves. Information about blood flow through the heart, the function of the valves in the heart as well as the motion of the heart walls is obtained. This test is totally painless and takes about thirty minutes.

Urinalysis: You will be asked to collect your urine over a 24-hour period and preserve it in a container. Tests will determine if your kidneys are strong enough to endure the transplant drugs you will need to take after the transplant. These drugs are very strong and can harm or damage your kidneys.

Psychological Testing: You may be asked to undergo psychological testing prior to transplant. This varies from center to center to the extent of the testing. It is used to determine the mental status of the patient and their ability to understand both the process and the responsibilities that a lung transplant poses. It may involve one visit or several or even some pre-transplant counseling.

Additional Testing: You will be given information about any additional testing that you will need to obtain on your own. An attempt will be made to schedule as many of these tests on the same day as possible in order to minimize the number of trips made to the hospital. However, it may not be possible to schedule all of these tests on one day so be prepared to spend several days getting your testing completed.

During the evaluation process, you will meet with the transplant pulmonologist and the transplant surgeon for an initial evaluation and examination. You will also meet with the transplant nurse coordinators and the transplant social worker.

Once all of your testing is completed and all of the results have been obtained, your case will be presented to the transplant committee for a recommendation. Not everyone presented to the transplant committee is found to be a suitable candidate for transplantation. The results from the testing will help the committee determine if transplantation is an appropriate option for you. If you are found to be a suitable candidate for transplantation then you will be "listed" as a transplant candidate.

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