title: Methadone and lung transplants.
abstract: OBJECTIVE
  The aim of this article is to better understand the role of the liaison psychiatrist regarding the pulmonary pre-transplantation assessment for a patient treated by methadone.
  
  
  METHODS
  At the beginning, we collected data concerning the different habits of patients requiring pulmonary transplantation. Through a literature review, we studied the possible guidelines related to this subject, the effects of methadone, the side-effects explaining the psychiatrist's concerns. Finally, this problem is involved in the bio-psycho-social model to underline the influence of methadone on post-operative prognosis.
  
  
  RESULTS
  In our database, only 4.3% of patients were treated by methadone. However, this addiction is one of the most important stressors for psychiatrists and involves a great deal of multidisciplinary staff time. There are absolutely no guidelines on this topic. Due to the action of methadone, the pulmonary, cardiac, urologic, drug and immune side effects are more understandable. Thanks to clinical labels, we are able to handle this dual problem. Different parameters are considered such as patient's history, drug addiction, deterioration of physical condition, possible surgery and its consequences, choice of treatment to better estimate the post-operative prognosis.
  
  
  CONCLUSIONS
  Until now, there is nor indication or contra-indication regarding the duration of treatment by methadone for patients requiring pulmonary transplantation. The main advantage is the patient's stabilization by minimizing possible relapses. This advantage is to compare the following major inconvenience: increased confusional risk, delicate management of the post-operative pain, negative impact on the immunity. The support, a double psychoeducation and the patient's decision making are to be encouraged.
authors: Université Catholique de Louvain, 5530 Yvoir, Belgium.
authors: Aurélie
authors: A
authors: Maricq
authors: Denis
authors: D
authors: Jacques
authors: Nicolas
authors: N
authors: Zdanowicz
authors: Eric
authors: E
authors: Marchand
authors: Patrick
authors: P
authors: Evrard
authors: Pierre
authors: P
authors: Bulpa
authors: Christine
authors: C
authors: Reynaert
mesh_terms: D000428:Alcohol Drinking; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D003221:Confusion / Q000139:chemically induced; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy*; D006801:Humans; D016040:Lung Transplantation / Q000523:psychology*; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000523:psychology* / Q000534:rehabilitation; D010348:Patient Care Team; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D012907:Smoking
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone