Our Evaluation Process
The evaluation process begins with a referral by:
- Local physician
- Patient (self-referral)
- Family member/Friend
- Insurance company
- Home care company
The transplant coordinator will discuss your diagnosis, history and current medial status with you before scheduling an official visit.
We depend upon the patient’s referring physician to provide us with a detailed medical history, which enables us to evaluate your condition and prognosis thoroughly.
We will need to see certain documents.
- Patient medical records
- A complete medical history
- Current physical examination
- Nutritional status
- Recent testing and laboratory
- TPN formulation (if applicable)
- Imaging on disc – computerized tomography (CT) scan, magnetic resonance imaging (MRI), X-rays, etc.
We will review all medical information and discuss with you and your referring physician. The transplant team will develop an individual schedule shortly after the review. A typical evaluation lasts three to five days and can be completed either in or outside of the hospital.
- Prompt evaluation is particularly important for patients with TPN complications or liver disorders
- The risk when two organs fail or other TPN-related complications develop is considerably greater than when only intestinal failure is present
- You will have several opportunities to discuss the evaluation, operative procedure as well as the post-operative timeframe.
- We know that discussing the transplant process can be overwhelming for patients and families and that you may not be able to recall all of your questions during your visit. We ask that you maintain a journal with your questions as they arise and feel free to contract us at any time
- Please, if possible, invite any family members or close friends to accompany you for the evaluation as they will be able to learn about the entire process and provide support to you during this time
- Remember that your transplant team members want to assist in ensuring a smooth evaluation stage for you and your family. Please be sure to communicate frequently so that we can help minimize any concerns that you may have.
The evaluation process is a multidisciplinary approach. You will meet with numerous members of the transplant team including:
- Transplant surgeons
- Transplant gastroenterologists
- Transplant coordinator
- Transplant social workers
- Transplant nutritionist
- Infectious disease specialist
- Financial coordinator
Some assessments include:
- Laboratory testing
- Liver function tests
- Vitamin levels
- Immunoglubulin levels
- Antibodies to cytomegalovirus, Epstein-Barr virus, Hepatitis panel, HIV, Human Leukocyte Antigen and Panel Reactive Antibodies
- Diagnostic procedures focusing on anatomy of the GI tract (motility studies, barium enema, upper GI studies, endoscopy, CT abdomen/pelvis)
- Nutritional status
- Vascular patency (assess internal jugular, subclavian and femoral veins)
- Infection history
- Immunologic status
- Psychosocial issues
- Working with consulting teams that consist of Cardiologists, Pulmonologists, Infectious Disease specialists, Neurologists, and Anesthesiologists
Your medical case undergoes a multidisciplinary review. Specialists make medical recommendations with the following people:
- Referring Physician
At this time, the transplant team will establish routine communication with the patient, family and referring medical team.
Following treatment at Mount Sinai, we will work with your referring physician to help maintain your optimum health level.
At the end of the evaluation, a transplant multidisciplinary meeting called a recipient review will take place. Next, we will finalize and notify you about a decision regarding your candidacy as soon as possible via phone. Finally, if we consider you a suitable candidate, we will place you on the official United Network for Organ Sharing list