Cardiac transplantation: candidate identification, evaluation, and management.
For more than 40 years, cardiac transplantation has been a treatment option for patients with severe heart failure in whom optimal medical management is no longer effective. Critical care nurses are integrally involved in the care of patients with severe heart failure who may benefit from cardiac transplantation and are in a special position to recognize potential candidates for transplantation. Understanding patient selection criteria, the evaluation process, and how patients are managed while awaiting transplantation is key to the knowledge and skills required. It is also important to understand the allocation of donor hearts as part of this process. The waiting period for a suitable donor heart can be long and a patient's condition may deteriorate, requiring an increase in pharmacologic bridges with intravenous inotropic agents or mechanical bridges with circulatory assist devices. Critical care nurses become important as a personal bridge to transplantation through their education of patients and families and helping them cope with their fears during the waiting period. Critical care nurses who possess knowledge of patient selection and organ allocation processes along with the skills of caring for this complex patient population can contribute to better outcomes for patients with heart failure who may be candidates for cardiac transplantation.
Sharp Memorial Hospital, San Diego, California 92123, USA.
Vicki
V
McCalmont
Linda
L
Ohler
D000075202:Contraindications; D003422:Critical Care / Q000458:organization & administration*; D018450:Disease Progression; D004867:Equipment Design; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016027:Heart Transplantation / Q000451:nursing* / Q000706:statistics & numerical data; D006354:Heart, Artificial; D006353:Heart-Assist Devices; D006801:Humans; D008403:Mass Screening; D024802:Nurse's Role; D009730:Nursing Assessment; D010348:Patient Care Team; D010353:Patient Education as Topic; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods / Q000451:nursing; D040841:Resource Allocation; D012944:Social Support; D009927:Tissue and Organ Procurement; D014481:United States / Q000453:epidemiology; D014850:Waiting Lists