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American Family Children's Hospital
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Lung Transplant Referrals

Referrals

If you are interested in having an evaluation to determine if you are a potential transplant recipient, you, your physician, or any other caregiver may contact the program.

All new patients and referring providers interested in determining whether lung transplantation is a potential option, please call (608) 265-5658 and ask to speak to one of the lung transplant coordinators.
 
You will be asked to provide the following information: name of potential candidate, address, phone number, date of birth, social security number, insurance information, brief medical history and disease, smoking history, height and weight, local primary physician and pulmonologist.
 
You will be asked to provide the following medical records, if available: 
  • Current history and physical
  • List of current medications/therapies
  • Lab and sputum culture results
  • Pathology reports/slides (if biopsy done)
  • Chest X-ray and CT reports and films
  • Pulmonary function reports
  • Any hospital admission/discharge reports
  • Echocardiogram report
  • Heart catheterization report