Psychological and psychosocial aspects of the solid organ transplant experience--a practice review

There is an increasing need for empirically based psychotherapy interventions for individuals and their caregiving systems undergoing the solid organ transplant process. Research suggests that the organ transplant recipient experiences an improvement in physical and social functioning and return to daily activities, but not consistently positive change in psychological health. The transplantation process leaves the recipient with a mixture of distressing and challenging experiences. Three temporal stages have been identified in the process: the pretransplant stage, preoperative/candidacy waiting period, and the posttransplant stage, each holding psychological and social issues. The construct of quality-of-life, identified by critical factors and benchmarks in the therapeutic process for transplant recipients, is defined differently in the medical and psychological literature. Differences are discussed in terms of therapeutic interventions. Caregivers are found to experience their own challenges when an intimate has a solid organ transplant. Therapeutic interventions for the caregiving system include stress management, psychoeducation, and repair of relational ruptures.