An evaluation helps the lung transplant team determine if transplantation is the best choice for your child at this time. Before an evaluation is scheduled, we will need to receive and review records from your child’s referring physician and get approval from your child’s health insurance provider.
The evaluation process usually takes four days and in most cases does not require your child to be admitted to the hospital. During the evaluation, our team will to get to know you, your child and your family, talk about what you can expect from our team and the evaluation process, and give you a chance to get to know our team.
We will also want to make sure your whole family understands the details of your child’s illness, risks, benefits and outcomes of lung transplants — as well as the process for lung transplant evaluation and listing.
Some tests your child may undergo during the evaluation include:
On the last day of the evaluation, you will meet with the transplant provider and transplant coordinator to review all available results, to discuss if the team feels your child is ready to be considered for transplant and how urgent it may be.
Moving Forward with a Transplant
If the team recommends a transplant, your child will be placed on the national waiting list as soon as possible. There are four steps to this process:
- Approval by the Cincinnati Children's medical review board
- Approval by the Ohio Solid Organ Transplantation Consortium (OSOTC)
- Additional financial approval from your child’s insurance company
- Relocation to the Cincinnati area
Your information will then be sent to the United Network of Organ Sharing (UNOS). Your transplant coordinator will let you know when this process is complete and answer any questions you may have.
Relocation is required for some, but an option for others. It will be important that you can travel to Cincinnati Children's in a timely fashion when a potential donor has been identified, generally within a 4-hour drive. Speak with your team about the need to relocate.
Lung Allocation Score (LAS)
There are a lot of factors considered when placing patients on the transplant list: age, severity of disease, lab tests, the need for mechanical ventilation and more. A Lung Allocation Score is created on a scale of 0 to 100. A higher number means a greater risk of death without a transplant, and therefore means your child will be the priority when a new lung becomes available.
We cannot predict when your child will get an offer for a transplant. While your child is on the transplant list, they will be seen in the Lung Transplant Clinic at Cincinnati Children’s routinely (weekly to every other week).
For children over 12 years old, the LAS is used to prioritize waiting list candidates based on unique factors, waitlist urgency, and post-transplant survival. Children under 12 are prioritized based on their medical condition and length of time on the transplant list.