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Palliative care in lung transplantation
Brandi Braud Scully1, Eric P Nolley2, Errol L Bush3
1Division of Thoracic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA; Johns Hopkins University Berman Institute of Bioethics, Baltimore, MD, USA.
Annals of Palliative Medicine
|June 13, 2021
Summary
Palliative care is an underutilized tool in lung transplantation, improving symptom burden and psychological distress for patients and families. Increased integration is needed to overcome barriers and optimize care throughout the transplant journey.
Area of Science:
- Pulmonology
- Transplant Surgery
- Palliative Medicine
Background:
- Palliative care's role in lung transplantation has significantly expanded over the last 20 years.
- It assists in candidate evaluation, optimization, and perioperative care, including extracorporeal cardiopulmonary life support (ECLS) bridging.
- Palliative care is an effective, yet underutilized, resource for lung transplant patients.
Purpose of the Study:
- To review the multifaceted benefits of palliative care in lung transplantation.
- To advocate for increased integration of palliative care in lung transplant programs.
- To delineate the potential benefits for perioperative lung transplant patients.
Main Methods:
- This is a review article.
- It synthesizes existing literature on palliative care in lung transplantation.
- It discusses barriers and facilitators to palliative care integration.
Main Results:
- Palliative care reduces symptom burden and psychological distress in primary and re-transplant candidates and recipients.
- It addresses specific needs in older adults, including cognitive impairment, depression, and frailty.
- Palliative care supports organ donor families and can mitigate issues in lung re-transplant patients with high morbidity.
Conclusions:
- Palliative care offers significant benefits across the lung transplantation continuum, from pre-transplant evaluation to post-transplant care.
- Barriers to palliative care integration are multifactorial, involving physicians, patients, and institutions.
- Optimizing palliative care integration is crucial for lung transplant practitioners to enhance patient outcomes.
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