Psychiatric considerations in the patient receiving organ transplantation: a clinical case conference.
Psychiatric consultations to evaluate a patient's suitability to receive organ transplantation can require the integration of multiple types and sources of information. A patient's social support network, history of treatment compliance, ongoing Axis I and Axis II disorders, and understanding of the procedure and follow-up required must all be evaluated during such a consultation. This article presents the case of a woman with borderline personality disorder who developed hepatic failure following a drug overdose, and discusses her evaluation for liver transplantation. The discussion frames the pertinent issues in the transplant evaluation and describes the perioperative (transplant) management of the borderline patient.
Huffman
Jeff C
JC
Massachusetts General Hospital, Boston, MA, USA. jhuffman@partners.org
Popkin
Michael K
MK
Stern
Theodore A
TA
D000082:Acetaminophen / Q000506:poisoning; D000328:Adult; D000700:Analgesics / Q000506:poisoning; D001521:Behavior Therapy; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology*; D015897:Comorbidity; D003693:Delirium / Q000175:diagnosis / Q000523:psychology; D003937:Diagnosis, Differential; D062787:Drug Overdose / Q000523:psychology; D004608:Eligibility Determination; D005260:Female; D006501:Hepatic Encephalopathy / Q000139:chemically induced* / Q000523:psychology / Q000601:surgery; D006801:Humans; D007165:Immunosuppression Therapy / Q000523:psychology; D016031:Liver Transplantation / Q000523:psychology*; D010348:Patient Care Team; D010349:Patient Compliance; D010552:Personality Assessment; D010817:Physician-Patient Relations; D011183:Postoperative Complications / Q000175:diagnosis / Q000523:psychology; D011570:Psychiatry; D012017:Referral and Consultation; D018570:Risk Assessment; D012803:Sick Role; D012944:Social Support; D016312:Treatment Refusal / Q000523:psychology
D000700:Analgesics; D000082:Acetaminophen