Psychiatric care of patients undergoing organ transplantation.
Transplantation provides life-saving therapy to critically ill patients with end-stage organ failure. We found that the specialized knowledge of mental health clinicians and physicians, committed to the evaluation and management of transplant recipients, is essential for the optimal care of these patients who require a life-long regimen of immunosuppressive medication and dependency on the transplant team. Critical issues requiring psychiatric input are frequently encountered in the following areas (1) patient selection and informed consent; (2) recognition and pretransplant treatment of psychiatric disorders; (3) substance or alcohol abuse; (4) compliance with medical regimens; (5) posttransplant psychosis; and (6) immunosuppressive/psychiatric drug-drug interactions. This review focuses on the priorities in psychological and psychiatric care of these unique patients.
Surman
Owen S
OS
Department of Psychiatry and Surgery, Massachusetts General Hospital, Boston, MA 02114, USA. osurman@partners.org
Cosimi
A Benedict
AB
DiMartini
Andrea
A
D000437:Alcoholism / Q000453:epidemiology; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D003693:Delirium / Q000453:epidemiology; D004347:Drug Interactions; D004992:Ethics, Medical; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016377:Organ Transplantation / Q000523:psychology*; D010349:Patient Compliance; D018579:Patient Selection; D010552:Personality Assessment; D011182:Postoperative Care / Q000523:psychology; D011183:Postoperative Complications / Q000523:psychology; D011618:Psychotic Disorders / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D007166:Immunosuppressive Agents