On Page Nav:
Our "I need a" series is a helpful guide to finding the care you need when you don't know where to start. Today, we're learning how to find a Transplant Surgeon.
If you may need transplantation (transplant) surgery to address a chronic health condition like liver failure, end-stage renal disease (ESRD) or heart failure, choosing your surgeon and transplant program is a big decision. So, before you start your search, let's answer some helpful questions.
What Organs Can be Transplanted?
Not every organ can be transplanted, and some are only transplanted in very specific cases. Organs that can be transplanted include:
- Heart
- Kidney
- Liver
- Lung
- Pancreas
- Stomach
- Small and large intestines
In some cases, parts of organs like heart valves and tissues like corneas and skin can also be transplanted.
What Kind of Surgeon Performs Transplants?
The label “transplant surgeon” is most often used to refer to liver and kidney surgeons that specialize in transplants because those are the most commonly transplanted organs. But because different types of transplants involve different organs, surgeons who perform transplants come from a variety of specializations. Knowing these terms can be helpful for your search. They include:
- Abdominal organ transplant surgeon — for abdominal organs like the liver, kidney, pancreas, stomach or intestines
- Liver surgeon (hepatic surgeon or hepatobiliary surgeon) — for liver transplants
- Kidney surgeon (renal surgeon) — for kidney transplants
- Cardiac surgeon — for heart transplants
- Thoracic surgeon — for lung transplants
- Cardiothoracic surgeon — this category includes both cardiac and thoracic surgeons
Can I Choose my Transplant Surgeon?
Unlike most surgeries, transplant surgery can only be performed at a designated transplant program. Organ transplants require a dedicated team of specialists including transplant surgeons, physicians, nurses, and coordinators to manage the transplant process. If you need multiple organs transplanted, coordinating that process is even more complex.
Because transplants require a large collaborative team, you will most likely not be able to choose your surgeon. But you can choose your transplant program, and evaluating surgeons that are part of the team is an important part of that decision.
How Do I Choose a Transplant Program?
For many types of transplants, you must stay near the program so you can come to the hospital for the procedure as soon as a viable organ becomes available. So looking for programs in your area can help narrow the search. The Organ Procurement and Transplantation Network (OPTN) offers a helpful tool for finding programs in your area. You can search by organ, region, and program type.
Once you find some programs to consider, you can review their team and evaluate their surgeons. Just remember that the surgeon is only part of a transplant program, and that you likely will not be able to choose a specific surgeon from that program when it comes time for your surgery.
What Credentials Should I Look For?
Evaluating transplant surgeons by looking at credentials alone isn’t enough, but it's a helpful place to start. Knowing that a surgeon has completed additional training or has been certified by a professional board is a good sign that they have the expertise you are looking for.
- Residency — All transplant surgeons will have completed a surgical residency, meaning that after medical school, they trained for years under the supervision of seasoned physicians.
- Fellowship — Fellowship is additional, focused training after residency. A fellowship-trained transplant surgeon has completed a specialized training program under the supervision of an experienced surgeon. Transplant fellowships are the main way that surgeons receive the necessary specialized training to perform transplant surgery.
- As with the types of surgical specialties that perform transplants, fellowships fall into broader categories based on the organs involved. They include:
- Transplant fellowships typically include liver, kidney, and pancreas transplant specialization.
- Cardiac transplant fellowships specialize in heart transplants and managing end-stage heart disease.
- Lung transplant fellowships focus on lung transplantation.
- Cardiothoracic/heart-lung transplant fellowships include training for both heart and lung transplantation, as well as heart-lung transplants, where both the heart and lungs are transplanted together.
- As with the types of surgical specialties that perform transplants, fellowships fall into broader categories based on the organs involved. They include:
- Board Certification — This voluntary process demonstrates that a surgeon has met rigorous standards set by their peers through a governing organization, or board. These boards are recognized by the American Board of Medical Specialties and the American Medical Association.
🚩 Not every area has a board certification. For example, cardiothoracic surgeons can become board certified by the American Board of Thoracic Surgery, but there is no specific board certification for heart transplant surgery.
- Professional Societies and Organizations — Membership in groups like the American Society for Transplant Surgery (ASTS) indicates that a transplant surgeon is active in their specialty's clinical and research communities.
A Word About Top Doctor Awards
When searching for a doctor of any kind, you'll probably come across advertisements for sites boasting Top Doctor lists, or you may find these awards mentioned in a surgeon's profile. While many of these awards are legitimate and are based on peer-nominated candidates and vetted feedback, not all lists are created equal. Some are essentially lists intended to promote only the doctors who have paid for the privilege. If you use a Top Doctor list in your search, make sure that's only part of your criteria.
Am I a Candidate for Transplant Surgery?
Because donor organs are in scarce supply, you must be evaluated to determine if you’re a good candidate for transplant surgery. Transplants are prioritized for patients that are most likely to safely receive the donor organ and adhere to the required lifelong maintenance.
Many people who need a transplant also have other illnesses (comorbidities) that may keep them from being added to the transplant list. It’s a good idea to work with a comprehensive transplant program that can help you address disqualifying factors and prepare you to be a stronger candidate for surgery.
What Happens if I’m Turned Away From a Program?
It is not uncommon for a transplant program to reject patients for a number of reasons. But it’s important to not give up just because a program didn’t consider you a good candidate. Some programs are more capable of supporting patients with complex conditions and have the necessary programs to help address any disqualifying factors. For example, if a cardiac condition is disqualifying you from a kidney transplant, treating that condition may help you qualify for your transplant. Some hospitals have dedicated programs designed to support people seeking transplants and help them become better candidates. It can also help to focus on programs that perform higher volumes of transplant surgeries or have experience with more challenging cases. So if at first you don’t succeed, keep trying.
How Do I Receive a Donor Organ?
Transplant surgery is different from other procedures in that there must be an appropriate donor organ available. So in most cases, it’s not as simple as finding a program and scheduling a procedure. Some types of donor organs can come from living donors, so it can be easier to find a match and plan for the surgery. But most transplant patients must wait for a viable donor organ to become available, and the supply of donor organs falls far short of demand.
What Else is Important to Look For?
Transplant surgery isn't just about the procedure. Because transplanted organs can be rejected by the body’s immune system, recipients must commit to a lifetime of antirejection medication and medical supervision. Guidance for nutrition, exercise, and careful monitoring of your health and progress are important parts of the transplant process. To make access to that care easier, you might want to focus on the most comprehensive programs and multi-specialty medical centers.
A comprehensive support team includes related specialists; for example, in addition to the transplant surgeon, a heart transplant team would include transplant cardiologists and infectious disease specialists. And experienced transplant coordinators are crucial for navigating the complex administrative process. No matter what program you choose, make sure to ask about what support you will have after your surgery.
Word of Mouth
Do you know anyone who has had a transplant with the program you're considering? It can be helpful to get feedback from someone who has been through the procedure and recovery process. Keep in mind that everyone's health circumstances are unique, so their experience won't be the same as yours. But speaking with others can help you feel better informed about the real-world results and can give you some insight into how the program treats and supports their patients.
🚩 Word of mouth can also be a great way to find a program you might not have considered, especially if someone you know had a positive experience working with them. But make sure to then research the program for yourself.
Online Communities
Online forums can be a valuable source of information while helping you connect with others that are going through a similar experience. They can also be a good resource for your loved ones and caregivers as they help you navigate your transplant journey.
So I Found Some Surgeons and Programs I Feel Comfortable With… Now What?
It's time to start making appointments. Reach out to your top choices to schedule a consultation, or consult.
During My Consultation, What Should I Ask?
In a word: everything. This meeting is your chance to learn about your surgical options, but it's also your opportunity to learn about their program. No question is silly or useless if it helps you feel more confident about the procedure. You will be asked about your medical history to determine if you are a candidate for transplant, so bring notes if you're concerned about remembering any complex medical information. Here are some helpful questions to consider:
- About the Program
- How many transplant surgeries have you performed? How many do you perform each year?
- What are the outcomes and survival rates of your program?
- Are your surgeons fellowship-trained? Do they have any board certifications or additional qualifications?
- Who is part of your care team? What specialists do you work with?
- Are you involved in clinical trials that I might be able to participate in?
- About Your Procedure
- Am I a candidate for transplant surgery?
- What will happen if you find a viable donor organ for me?
- Do you perform living donor transplants?
- How long will I have to wait for my procedure?
- Are there any procedures or treatments that can support my health while I wait for my transplant surgery?
- What will the transplant surgery involve?
- What are my risks? What complications have you seen?
- Will I need to stay in the hospital? If so, for how long?
- What will I feel after my surgery?
- How long after the surgery will I start to feel better?
- How much scarring will there be?
- What medications will I need to take?
- Is a minimally invasive or robotic approach an option for me?
- What support will I need during recovery and beyond?
- How much will this procedure help me?
Do They Take My Insurance?
Money might not seem important when your health is at stake, but surgery can be expensive. Avoiding another stressful element can help you focus on your health. Transplant surgery is very expensive compared to other procedures, so it is important to know ahead of time if your insurance won't cover the procedure, or will only cover some of the costs.
Most transplant surgeries are covered at least in part by insurance, but not all insurance companies have the same eligibility requirements. So contact your insurance company to confirm your eligibility. Some insurance plans also require a referral, so talk to your primary doctor about what you'll need.
Transplant coordinators and social workers are part of every qualified program. They can help you navigate these administrative challenges and direct you to helpful resources.
Should I Get a Second Opinion?
Absolutely. Even if you think a program is perfect for you, a second opinion can make you feel more confident about your decision. It can also help you become better educated about the procedure and your options. Second opinions can often be done with telehealth appointments, so they may not be as challenging to schedule.
🚩 Be wary of any program that discourages you from getting a second opinion. Transplant surgery is a major decision, so it’s important to get all the information you can and to consider every option.
What Other Factors Should I Consider?
The decision to have transplant surgery is about you and your health, so you should consider what's important to you. If you've reduced your options to a few programs that have convinced you they will provide the best care possible, practical considerations may help you make the final decision. These include:
- Is the program or hospital close to home? Or is it worth it to travel for your procedure, knowing you will have to stay nearby for months or even years?
- Is finding an in-network program a priority because of your health insurance?
- Am I able to pay for a procedure out of pocket if my insurance doesn't cover it?
- How urgent is your health issue? Are there other treatments that can help you while you wait for an available donor organ?
Once you have settled on a transplant program, it's time to focus on getting ready for your procedure. That means following all instructions your transplant team gives you, including staying ready for when a viable donor organ becomes available.
Transplant surgery can be a life-changing operation, and it can dramatically improve your quality of life and improve your overall health and self-esteem. Choosing the right program can help you look and feel like your best self.
Related