Becoming a Patient / Transplant Evaluation Information
Becoming a patient at MedStar Georgetown Transplant Institute requires several important steps. These include:
- A referral by another physician, self, or other medical professional
- Pre-transplant evaluation, including interviews
- Cleared for transplant
The pre-transplant evaluation is conducted to determine if your overall health and existing medical conditions are such that you are eligible for transplant surgery. This evaluation includes the following:
- Initial interview
- Review of medical history
- Physical examination
- Psychosocial evaluation with a trained social worker
- Financial counselor to review insurance issues and medication funding
- Blood tests for tissue typing and antibody screening
- Screening for living donors (including overall health check and blood test)
- Consultations with various specialists
- Presentation to multidisciplinary pre-transplant committee to determine suitability
Additional testing may be required, depending on your individual needs.
Transplant Waiting List
Following the evaluation, the team meets to determine your eligibility to be placed on the transplant waiting list. You are quickly notified of the decision. While you wait for a transplant it is important to manage your condition. [Link to “Managing Your Condition Before Transplantation” page]
If the evaluation process indicates that you qualify for transplantation, patients who do not have a living donor are placed on the waiting list for a cadaveric transplant. The allocation of organs on the waiting list is based on a point system. When a donor becomes available anywhere in the country, the blood type and tissue type of the donor is determined. That information is compared to the tissue typing of all patients waiting for a transplant with that blood type.
A computerized list is generated through The United Network for Organ Sharing (UNOS) in Richmond, Virginia. This list shows if there are any perfect matches for this particular donor in the country. If so, patients who are a perfect match are given the most priority for that particular donor. After the perfect matches are determined, then the rest of the patients with that blood type are listed according to how many points they have. The point system is based on several factors, including the match, how long the patient has been waiting, and the immune status of the patient.
Every patient receives a comprehensive packet of information, describing the entire process and giving important information for the transplantation process.
Managing Your Condition Before Transplantation
Once you have been listed with the United Network for Organ Sharing, the wait for a donor organ to become available can be as short as a few hours or as long as several months or years. Waiting for a transplant can be a difficult process for you and your family.
The MedStar Georgetown Transplant Institute team will do all they can to help you during this waiting period and encourage you to follow these guidelines:
- Have your PRA (Percent Reactive Antibody) taken at least once a month. This measures the number of antibodies in your blood that may reject a transplanted organ. You must have this measured once a month because if a donor organ becomes available, a final cross-match will be performed immediately before surgery to minimize the chance that the donor organ will fail.
- Try to stay as healthy as possible and take your medications as prescribed.
- Follow dietary and exercise guidelines. Weight management is very important during while waiting for a transplant.
- Remain as active as possible as your condition will allow.
You should let us know if any of the following occur:
- Infection, illness, or hospitalization
- Any change in your health
- Traveling out of town: we will need all phone numbers in case we need to reach you
- Demographic data: if any of your contact numbers change, please let us know
Keep in touch every two to three months, even if no changes occur.
Immediately after surgery, you will be transferred to the intensive care unit where you will spend several days as the Transplant Team monitors you very carefully. Your pain will be controlled with medications, and we will do everything we can to make sure you are as comfortable as possible. Most transplant patients have a significant reduction in pain during the first few days after surgery. Some people experience prolonged discomfort.
After your stay in the intensive care unit, you will be transferred to the Transplant Unit, where you will be instructed on how to assume responsibility for your everyday care. You will be encouraged to get out of bed at least three times a day and walk around your room and the halls. This increases your circulation and aids in healing.
You must remain in the local area for four to six weeks post-discharge for monitoring.
Possible Risks and Complications
Your Transplant Team is watching for the following possible complications:
- Acute rejection of the new organ
- Delayed functioning
- Damaged bile ducts or bile leaks
- Recurrence of the original disease
- Blood clots
- Bleeding problems
Please do not be scared or anxious about possible complications. These are relatively rare, and our team has many solutions for possible complications. All transplants carry risk and we do everything we can to minimize those risks.
Monitoring Your New Organ
Blood tests are continually monitored for the first few days after transplantation. These tests are monitored daily until you leave the hospital, and then weekly in the office thereafter. After the first month following the transplant, tests are done less frequently.
Keeping Your Organ Healthy
The transplant process is a long and complicated one. Now that your healthy organ is functioning inside your body, you must assume responsibility for your everyday care.
We know this can be the scariest part of the transplantation process for some patients, and we have numerous support systems set up to help you, including your post-transplant coordinator.
Steps to care for your new, healthy organ include:
- Take all your medications and follow your medication schedule.
- Avoid infections: stay away from people with viral infections or colds for the first few months after transplant.
- Stay in contact with your support services: Always call your nurse or doctor after transplant for any new symptoms that arise, including bleeding, fevers, diarrhea, or other problems.
- Follow your diet: you are prone to fluid retention, and eating the prescribed diet with low salt and simple sugars is important early after the transplant.
- Please follow your patient discharge instructions carefully.
If you are considering an organ transplant, this general information may be helpful, no matter the type of transplant you need. Read the following for some answers to frequently asked questions and to learn more:
- Becoming a Patient
- Transplant Evaluation Information
- Becoming a Living Donor
- Managing Your Condition Before Transplantation
- Transplant Recovery
- Keeping Your Organ Healthy
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Research is a critical part of what we do at MedStar Georgetown University Hospital. Learn more about our research on treating and managing advanced disease and transplantation surgery.