title: Palliative care issues in heart transplant candidates.
abstract: OBJECTIVE
  Heart failure is a serious condition and equivalent to malignant disease in terms of symptoms burden and mortality. Presently, only a comparatively small number of heart failure patients receive specialized palliative care. A literature search was conducted with the terms, palliative care and heart failure, using the electronic databases of PubMed and MEDLINE.
  
  
  RESULTS
  Nine-hundred and five articles were reviewed and of those, 78 articles discussed clinical trials in palliative care and heart failure. A complex set of management tools and strategies were used and recommended, including but not limited to lifestyle modification, exercise programs, pain and sleep disorder management, and support in end-of-life care. Limited data are available of using palliative care in heart transplant candidates prior to transplant surgery.
  
  
  CONCLUSIONS
  Diminishing quality of life prevails throughout the course of chronic heart failure. Therefore, palliative care should be integrated into heart failure management. Heart transplant candidates may benefit from early palliative care involvement independent of the clinical course and outcome. Because of gaps in current scientific literature on palliative care, end-of-life care, and hospice care and the services rendered, further research is necessary to encourage healthcare professionals to introduce palliative care as an early resource in chronic disease progression.
authors.affiliation: aDSMI, Beverly Hills bCedars Sinai Medical Center, Los Angeles, California cUSA, St Joseph Hospital, Chicago, Illinois, USA.
authors.forename: Demian
authors.initials: D
authors.lastname: Muhandiramge
authors.forename: Dioma U
authors.initials: DU
authors.lastname: Udeoji
authors.forename: Olivia S
authors.initials: OS
authors.lastname: Biswas
authors.forename: Parag
authors.initials: P
authors.lastname: Bharadwaj
authors.forename: Leila Z
authors.initials: LZ
authors.lastname: Black
authors.forename: Karen Angelus
authors.initials: KA
authors.lastname: Mulholland
authors.forename: Concetta
authors.initials: C
authors.lastname: Moschella
authors.forename: Ernst R
authors.initials: ER
authors.lastname: Schwarz
mesh_terms: D002908:Chronic Disease; D002986:Clinical Trials as Topic; D004417:Dyspnea / Q000523:psychology / Q000628:therapy; D006333:Heart Failure / Q000523:psychology* / Q000601:surgery / Q000628:therapy*; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D010146:Pain / Q000523:psychology; D059408:Pain Management / Q000379:methods; D010166:Palliative Care / Q000458:organization & administration*; D011788:Quality of Life; D013727:Terminal Care