title: Preoperative predictors for postoperative problems in heart transplantation: psychiatric and psychosocial considerations.
abstract: The psychiatric and psychosocial evaluation of the heart transplant candidate can identify particular predictors for postoperative problems. These factors, as identified during the comprehensive evaluation phase, provide an assessment of the candidate in context of the proposed transplantation protocol. Previous issues with compliance, substance abuse, and psychosis are clear indictors of postoperative problems. The prolonged waiting list time provides an additional period to evaluate and provide support to patients having a terminal disease who need a heart transplant, and are undergoing prolonged hospitalization. Following transplantation, the patient is faced with additional challenges of a new self-image, multiple concerns, anxiety, and depression. Ultimately, the success of the heart transplantation remains dependent upon the recipient's ability to cope psychologically and comply with the medication regimen. The limited resource of donor hearts and the high emotional and financial cost of heart transplantation lead to an exhaustive effort to select those patients who will benefit from the improved physical health the heart transplant confers.
authors.affiliation: University of Minnesota, Minneapolis, MN, USA.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Rivard
authors.forename: Christina
authors.initials: C
authors.lastname: Hellmich
authors.forename: Barbara
authors.initials: B
authors.lastname: Sampson
authors.forename: Richard W
authors.initials: RW
authors.lastname: Bianco
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Crow
authors.forename: Leslie W
authors.initials: LW
authors.lastname: Miller
mesh_terms: D000223:Adaptation, Psychological / Q000941:ethics; D000367:Age Factors; D003220:Conflict, Psychological; D005190:Family / Q000523:psychology; D016027:Heart Transplantation / Q000009:adverse effects* / Q000941:ethics / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D018579:Patient Selection / Q000941:ethics; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods / Q000523:psychology; D011369:Professional-Patient Relations; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012307:Risk Factors; D012649:Self Concept; D018434:Sickness Impact Profile; D012944:Social Support; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D035502:Trust; D014850:Waiting Lists