Quan M. Bui|Larry A. Allen|Lisa LeMond|Michela Brambatti|Eric Adler
Psychosocial Evaluation of Candidates for Heart Transplant and Ventricular Assist Devices: Beyond the Current Consensus
University of California, San Diego|University of Colorado Anschutz Medical Campus|University of Colorado Denver|Mayo Clinic Hospital|University of California, San Diego|University of California, San Diego
advanced heart failure therapies including heart transplantation durable mechanical circulatory support available limited number patients scarcity donors expense large burden care importance psychological social determinants health including cognitive status health literacy psychopathology social support medical adherence substance abuse emphasized advanced heart failure amplified context mechanical circulatory support heart transplantation psychosocial assessment advanced heart failure therapy candidates remains largely subjective requiring multidisciplinary evaluation may include psychiatrists social workers case managers financial coordinators pharmacists clinicians objective toolsincluding stanford integrated psychosocial assessment transplantation psychosocial assessment candidates transplantation transplant evaluation rating scalewere developed validated limited populations help standardize evaluation process small retrospective studies inconsistently shown tools may predict clinical outcomes transplant population higherrisk scores associated readmissions rejection episodes infections however difficult show tools predict mortality applicability mechanical circulatory support population less studied international society heart lung transplantation released consensus statement 2018 promote consistency psychosocial evaluation across advanced heart failure programs lacks specific recommendations given current state evidence stateoftheart review expands current consensus critically reviewing current studies supporting available objective assessment tools proposing psychosocial evaluation framework uses multidisciplinary approach offering future directions research