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The Use of Palliative Care in Organ Transplant Patients and End-of-Life Issues

  • Jenny S. Ayala
  • Joseph LowyEmail author
Chapter

Abstract

Palliative care has been shown to improve quality of life and even prolong life in patients with certain types of malignancy and end-organ failure. Several studies have now demonstrated a beneficial impact of palliative care on the transplant patient. While hospice provides care for patients whose survival is expected to be less than 6 months, palliative care is the specialized care for the patient with serious illness and can be provided at any stage of the disease. All transplant candidates, by definition, qualify. Like transplant medicine, palliative care is also interdisciplinary. It is person/family centered and provides support along with aggressive symptom management. Patients are screened for pain and other physical symptoms as well as for psychosocial and spiritual distress. Palliative care also fosters communication between the patient/family and health-care providers. The patient’s values and principles are elicited so that concordant medical care is provided. Implementing palliative care, sometimes referred to as supportive care early in the disease trajectory has helped transition patients into hospice care once curative options have been exhausted. This chapter will elucidate why patients with organ failure who are candidates for transplantation or patients suffering from complications of transplantation are excellent candidates for palliative care and why a palliative care provider should be part of the transplant interdisciplinary team.

Keywords

Organ transplantation Role of palliative care Understanding the difference between palliative and hospice care Review of end-stage organ failure diseases and the role of palliative care End-stage heart failure End-stage lung failure End-stage liver failure End-stage kidney failure Bone marrow transplantation Importance of prognostication Palliative Performance Scale Prognosticating survival in non-cancer patients Symptom management in chronic illness and the role of palliative care End-of-life care for transplant patients 

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Authors and Affiliations

  1. 1.Hospice and Palliative Medicine, Jacobi Medical CenterBronxUSA
  2. 2.Palliative Care, NYU Langone HealthNew YorkUSA

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