>> As we've mentioned before, the most important limiting factor in the number
of lung transplantations performed nationwide is the lack of suitable donors.
That means that every year there are more people who need a lung transplant than can get one;
therefore it is important that these available donor organs are allocated carefully and fairly.
As with other organ transplants, there is a waiting list for patients needing donor lungs.
The Organ Procurement and Transplantation Network, or OPTN,
which is managed by the United Network for Organ Sharing, or UNOS,
maintains the only national patient waiting list for organ transplantation.
Once you have successfully completed your medical and surgical evaluations,
your case will be referred
to our multidisciplinary lung transplant evaluation team.
Each case is presented and discussed in depth.
After a full review of your individual case, the team will make a recommendation
about whether you could benefit from lung transplantation and if you meet the criteria
to be placed on the waiting list.
After your case has been reviewed and you are listed,
your transplant team will determine whether a single or a double lung plant is needed based
on your medical condition and history.
It is important to remember that not everyone can be wait listed for new lungs.
The evaluation team may determine that you are too sick to benefit from a transplant
or your physical condition is too diminished to withstand the rigors of surgery.
If this happens, your pulmonologist will continue caring for you
and giving you the best care possible.
Once you are on the list, you will be given a lung allocation score.
It is a number that comes from your condition, the results of your physical exam,
diagnostic testing, and it reflects how sick you are.
It is used to determine your placement on the waiting list.
With the lung allocation score, whoever's the sickest will go to the top of the list.
When lungs become available, a suitable match is based on blood type and size.
So if an organ becomes available that's from a donor matching your blood type
and is of the correct size for you, your surgeon will then evaluate that lung.
If it is suitable for transplantation, you will likely be offered that lung.
Getting listed comes with possibilities.
While waiting for new lungs to come, you must stay in close contact with the transplant team.
Once suitable lungs become available,
the transplant coordinators have one hour to contact you.
Transplant coordinators must speak to you.
They will not leave a message on your answering machine telling you new lungs have available;
therefore you must supply current phone numbers and be reachable when the call comes.
If you're relying on a cell phone, make sure you are in a cell phone reception area,
otherwise you may miss this call.
An hour goes by very quickly.
Due to the limited supply of donor organs, this may be your only chance for a transplant.
Once you are listed, you should stay within a four hour radius of Ann Arbor.
If you are outside this radius, you will need to arrange for air transport to get here
in the four-hour window after the call comes or you will need
to be placed on hold for a transplant.
Talk to the social worker if you need help with advanced directives,
a durable power of attorney, or a living will.
If your health or medications change while you are on the list, tell your coordinator.
This includes getting a cold, flew or infection.
If you are hospitalized or your breathing deteriorates,
you're placed on antibiotics your prednisone dose changes, you experience a change
in your oxygen need, tell your coordinator.
We can't perform a lung transplant while you are sick; therefore your status
on the list would change to on hold until you're well again.
Other reasons that may cause your status to change
to on hold include changes or lapses in your insurance.
There may be social issues that cause you to put your wait list status on hold.
It is your responsibility to maintain good health to the best of your ability while waiting
for a transplant; however, if you choose not to follow the substance abuse policy,
miss appointments, won't take your medicines,
don't follow your lung transplant team's recommendations, and don't get your lab tests
as required, you can be removed from the list.