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Murakami N, Baggett ND, Schwarze ML, Ladin K, Courtwright AM, Goldberg HJ, Nolley EP, Jain N, Landzberg M, Wentlandt K, Lai JC, Shinall MC, Ufere NN, Jones CA, Lakin JR. Top Ten Tips Palliative Care Clinicians Should Know About Solid Organ Transplantation. J Palliat Med 2022; 25:1136-1142. [PMID: 35275707 PMCID: PMC9467633 DOI: 10.1089/jpm.2022.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Solid organ transplantation (SOT) is a life-saving procedure for people with end-stage organ failure. However, patients experience significant symptom burden, complex decision making, morbidity, and mortality during both pre- and post-transplant periods. Palliative care (PC) is well suited and historically underdelivered for the transplant population. This article, written by a team of transplant specialists (surgeons, cardiologists, nephrologists, hepatologists, and pulmonologists), PC clinicians, and an ethics specialist, shares 10 high-yield tips for PC clinicians to consider when caring for SOT patients.
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Affiliation(s)
- Naoka Murakami
- Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nathan D Baggett
- Division of Emergency Medicine, Health Partners Institute/Regions Hospital, St. Paul, Minnesota, USA
| | | | - Keren Ladin
- Department of Occupational Therapy, Tufts University, Medford, Massachusetts, USA.,Department of Community Health, Tufts University, Medford, Massachusetts, USA
| | - Andrew M Courtwright
- Department of Pulmonary and Critical Care Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hilary J Goldberg
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Eric P Nolley
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nelia Jain
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Michael Landzberg
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kirsten Wentlandt
- Division of Palliative Care, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Jennifer C Lai
- Department of Medicine, University of California, San Francisco, California, USA
| | - Myrick C Shinall
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Section of Palliative Care, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nneka N Ufere
- Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Christopher A Jones
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Joshua R Lakin
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Khush KK, Hsich E, Potena L, Cherikh WS, Chambers DC, Harhay MO, Hayes D, Perch M, Sadavarte A, Toll A, Singh TP, Zuckermann A, Stehlik J. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-eighth adult heart transplantation report - 2021; Focus on recipient characteristics. J Heart Lung Transplant 2021; 40:1035-1049. [PMID: 34419370 DOI: 10.1016/j.healun.2021.07.015] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 02/06/2023] Open
Affiliation(s)
- Kiran K Khush
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Eileen Hsich
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Luciano Potena
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Wida S Cherikh
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Daniel C Chambers
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Michael O Harhay
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Don Hayes
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Michael Perch
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Aparna Sadavarte
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Alice Toll
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Tajinder P Singh
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Andreas Zuckermann
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
| | - Josef Stehlik
- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas.
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- The International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry, Dallas, Texas
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Diaz Milian R. Barriers to High Quality End of Life Care in the Surgical Intensive Care Unit. Am J Hosp Palliat Care 2020; 38:1064-1070. [PMID: 33118372 DOI: 10.1177/1049909120969970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
End of life discussions frequently take place in surgical intensive care units, as a significant number of patients die while admitted to the hospital, and surgery is common during the last month of life. Multiple barriers exist to the initiation of these conversations, including: miscommunication between clinicians and surrogates, a paternalistic approach to surgical patients, and perhaps, conflicts of interest as an unwanted consequence of surgical quality reporting. Goal discordant care refers to the care that is provided to a patient that is incapacitated and that is not concordant to his/her wishes. This is a largely unrecognized medical error with devastating consequences, including inappropriate prolongation of life and non-beneficial therapy utilization. Importantly, hospice and palliative care needs to be recognized as quality care in order to deter the incentives that might persuade clinicians from offering these services.
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Affiliation(s)
- Ricardo Diaz Milian
- Department of Anesthesiology and Perioperative Medicine, 160343Augusta University, Augusta, GA, USA
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