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Following transplantation, all patients must follow a medical regime, which includes the need for lifetime medications designed to prevent rejection of the transplanted organ. The transplant team recognizes this and is committed to working with patients after the transplant to regulate medications and prevent the body from rejecting the transplanted organ.
The transplant teams understand that the decision to proceed with transplantation must be made in consultation with all individuals involved in the patient's care, including the patient and their family. The patient and family input is vital, as they must clearly understand the risks involved in transplantation and the commitment to a lifetime of care. In return, transplantation offers the hope that the patient can return to an improved quality of life.
Physicians can download the Transplant Referral Data Sheet  (PDF, 32K), which can be filled out and faxed back to St. Luke's Transplant Services Department (fax: 832-355-6696). Kidney transplant patients must fill out a separate transplant referral form. To view these forms, you must have the free Adobe Acrobat Reader.
Read about:
 Heart Transplant
Kidney Transplant
Lung Transplant
Liver Transplant
Heart Transplant
A heart transplant may be recommended for patients with end-stage heart disease which can be due to a multitude of factors, including coronary artery disease, cardiomyopathy (a chronic disease involving the heart muscle), heart valve disease or severe congenital heart disease.
Many patients may be referred to St. Luke's Heart and Lung Transplant and Treatment Center, which brings together medical treatment, surgery, transplant, and implantable devices to help patients with heart failure and other cardiovascular problems. The Center is located in The Texas Heart Institute at St. Luke's Hospital – The Denton A. Cooley Building in heart of the Texas Medical Center. Transplantation is recommended for patients whose heart disease is so severe that no other options are available. During the evaluation process and the wait for transplantation, St. Luke's cardiovascular staff is committed to providing the best care possible.
St. Luke's is also working with its research partner, the Texas Heart Institute, to find new ways to help failing hearts last longer, and in some cases, become stronger. The most high-profile product of this research is the success of recent trials of the Jarvik 2000, a heart assist device that may one day serve as an effective bridge to transplant, or possibly a permanent device, for countless heart patients.
St. Luke's Heart Exchange is a support group that provides emotional support for potential heart transplant patients and those who have received heart transplants at St. Luke’s.
To contact the heart transplant coordinator, please call 832-355-2285.
Kidney Transplant
Kidney (renal) failure occurs when the kidneys lose their ability to adequately filter waste products from the blood, and to regulate the body's balance of salt and water. Eventually, urine production may slow or stop, and waste products and water accumulate in the body. When kidneys reach end stage, either dialysis or kidney transplant will be needed. Kidney failure may have a recent (acute) onset, or be longstanding (chronic) or end-stage, in which dialysis or transplant may be necessary to remain alive.
Kidney transplants are the most common organ transplant operation in the United States. St. Luke's Episcopal Hospital transplant surgeons and kidney specialists have cared for over 1200 kidney transplant patients since 1986. Their experience and the commitment of the entire team of specialists makes St. Luke's Episcopal Hospital an excellent choice for people facing the prospect of a kidney transplant.
General Information: A kidney transplant can be obtained two ways:
Deceased donation – Patients most commonly will receive a kidney from someone who is brain dead and the family has agreed to donate their organs. Information about obtaining this type of transplant can be viewed in this article and in the "Kidney Recipient Handbook."
Living renal donation – A relative, friend, or loved one may offer to donate one of their kidneys to you. Information for you and the donor can be viewed below in the “A Guide to Living Kidney Donation.”
Initiating the Evaluation: To initiate the evaluation process, you must first complete a referral for kidney transplant. You may initiate a referral by phone, or by submitting an online application. All information must be completed for the team to process the referral. If you have any questions, or need assistance filling out the referral, please contact us at 832-355-3128. The dialysis nurse or social worker may also be able to assist you in filling out this form.
Once the referral is completed and submitted, you may choose to view the St. Luke’s recipient handbook online, or you may request a copy be mailed to your home.
The insurance verifications department will contact your insurance company to obtain approval for the evaluation at St. Luke’s. This process may take up to four weeks. After approval is obtained, the transplant team will contact you to schedule your evaluation.
Transplant Evaluation: You will have a thorough evaluation of your medical condition so that the transplant team can assess the specific risks and benefits of renal transplantation for you. These results will help the team in making decisions about your suitability as a candidate for transplantation.
The evaluation requires two to five days of testing, which is done on an outpatient basis. Generally, the evaluation follows these steps (scheduled by the transplant coordinator):
- Physical Examination - The Nephrologist will perform a complete examination and will review medical records.
- Renal Transplant Coordinator – The coordinator will provide you with information about kidney transplant, the evaluation process, and what to expect before and after transplantation.
- Transplant Financial Counselor – The counselor assesses financial needs and insurance before and after transplant.
- Nutritional Evaluation - A dietitian will evaluate your current nutritional status, and discuss your diet now and after transplantation.
- Psychosocial Evaluation - A clinical social worker will meet with you and your family to gather information about your lifestyle, including support system, education, and work history.
- Tests Required for Transplant Candidates:
- Blood tests - Blood tests help assess your overall physical condition.
- Tissue typing - Tissue typing is a special blood test that helps the Transplant Team find a donor kidney that matches and provides valuable information about your body's immune system.
- Colonoscopy – A procedure to screen for colon cancer or anyone over age 50.
- Chest X-ray - The test assesses the size of your heart and any lung abnormalities
- Voiding cystourethrogram (VCUG) - The test assesses the function of the lower urinary tract.
- Abdominal US - Examines the kidneys, liver, and gallbladder for the presence of cysts, stones, or other abnormalities.
- TB Skin testing - A small amount of solution is injected under the skin on your forearm to determine if you have been exposed to tuberculosis.
- Gynecological exam – All women will need a gynecological exam within the last year. Mammograms are also required for all women over age 40.
- Pulmonary function studies - If you have a history of lung disease or tobacco use, your transplant work-up may include pulmonary (lung) function studies.
- Cardiac tests – These tests will assess your heart function and will include an echocardiogram, and electrocardiogram (EKG or ECG). A stress test, and a cardiac catheterization are done if indicated.
Medical Review Board: When the entire transplant evaluation has been completed, Your case will be presented to the Medical Review Board. The review board determines if transplant is the best option for you. Board Members include representatives from Nephrology, the Transplant Surgeon, Transplant Coordinators, Dietary, Social Services, and the Business Office. You will be notified of any recommendations by one of the transplant coordinators.
The Waiting Period: If you are accepted for transplantation, you will be placed on a national computer list of active candidates waiting for a donor. Recipients are chosen according to a complex set of criteria, including blood type, body and organ size, physical condition, age, and length of time on the waiting list. The United Network for Organ Sharing (UNOS) coordinates the equitable sharing of organs throughout the United States and oversees all donor centers and procurement agencies.
The waiting period can be several months to several years, depending on your blood type and antibody level. The transplant coordinators must be able to locate you 24 hours a day, and you must be able to reach the hospital within a reasonable amount of time once a kidney becomes available. When a donor kidney is found, you will be notified immediately and given instructions.
Live Donation: The other option available to kidney recipients is a living donor. The potential donor will undergo an extensive evaluation at time of the recipient’s approval on the transplant list. When people receive a kidney from a live donor, they do not have to wait on the cadaveric transplant list and can schedule the surgery at the convenience of the recipient, donor, and surgeons. Please refer to “A Guide to Living Kidney Donation” for more information.
A Laparoscopic nephrectomy is one of two possible types of surgeries you may have when you donate a kidney to a loved one. This procedure is less invasive and has a faster recovery time than a traditional open nephrectomy. The procedure requires cutting less muscle tissue, and therefore creating less area to heal. A Laparoscopic nephrectomy is not right for everyone, so please ask your coordinator if you have any questions.
If you still have questions about kidney transplantation, the evaluation process, living donation, or any other matter, feel free to contact our office at 832-355-3128.
Lung Transplant
The lung transplant program at St. Lukes Episcopal Hospital, in association with Baylor College of Medicine, has been performing successful lung and heart-lung transplants since the 1980s. In cooperation with physicians Texas-wide, we are committed to changing the number of lives lung diseases claim so early.
St. Luke's Heart and Lung Transplant and Treatment Center brings together medical treatment, surgery, transplant, and implantable devices to help patients with heart failure and other cardiovascular problems. The Center is located in The Texas Heart Institute at St. Luke's Hospital – The Denton A. Cooley Building in heart of the Texas Medical Center.
Lung transplants may be recommended for patients with severe end-stage lung disease caused by emphysema, cystic fibrosis, chronic diseases such as sarcoidosis, permanent scarring and thickening of lung tissue (idiopathic pulmonary fibrosis), or congenital diseases. After a thorough evaluation, recommendations may include either single lung transplant, double lung transplant or heart and lung transplant.
For every two patients that receive a lung transplant, one dies while waiting. In 2000, 956 patients received a lung transplant nationwide, and 481 died while waiting, down from 587 the previous year. Organ shortage is the main cause, although late referrals may also play a role.
The lung transplant experts at St. Luke's have suggested some web sites where you can find additional information. Please keep in mind that our staff has not reviewed every page of these sites and is not responsible for the information contained within them.
To contact the lung transplant coordinator, please call 832-355-3952.
Liver Transplant
Physicians at the Texas Center for Liver Disease are among the most experienced group of liver specialists in the country. These physicians are all board certified in either internal medicine and gastroenterology, or general surgery and critical care medicine. They are experts in handling all facets of care, ranging from evaluation of patients with abnormal liver function, treatment for patients with chronic liver disease, and transplantation.
The development of effective immunosuppressive drugs and the refinement of surgical procedures have led to remarkable improvements in the long-term success of liver transplantation, and St. Luke's physicians have helped lead the way. Transplantation is widely recognized as an effective option for the treatment of end-stage liver disease, especially for patients with chronic diseases such as hepatitis C.
To contact the liver transplant coordinator, please call 832-355-4393.
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