Lung Transplant Referral Checklist
When referring patients to the Lung Transplantation Program at UPMC, please include the information listed below.
Demographic Summary
- Patient name
- Patient date of birth
- Patient address
- Patient phone number
- Patient social security number
- Emergency contact information (including emergency contact's home and cell phone numbers)
Insurance Information
- Name of subscriber
- Subscriber’s relationship to patient
- Identification number
- Group number
Clinical Summary
- Most recent outpatient records
- Discharge summaries from prior hospitalizations
- All operative notes, including surgically placed lines
- Radiologic studies
- Recent laboratory reports
- If your patient is currently hospitalized, current hospital records
- Reports from previous transplant evaluations, including letters of acceptance or decline, if applicable
Referring Physician Information
- Referring physician name
- Referring physician phone and fax numbers
- Primary care physician name
Mailing Address and Contact Information
Mail patient records to:
Cardiothoracic Surgery -- Lung Transplantation
UPMC Presbyterian, Suite C-900
200 Lothrop St.
Pittsburgh, PA 15213
Attn: Lung Transplant Coordinators
For more information or to refer a patient:
- 24-hour physician referral line: 1-800-544-2500
- Phone: 412-648-6202
- Fax: 412-648-6355
- E-mail: cttransplant@upmc.edu