Psychiatric Issues in Organ Transplantation

John E. Franklin and Roslyn M. Paine

The myriad of technical advances in solid organ transplant over the past 20 years has challenged the field in expected and unexpected ways. The increased survival rates and quality of life has increased referrals and demand for organ transplantation. This increased demand however has highlighted the shortage of available donor organs. This dilemma serves as a backdrop to many of the psychosocial issues discussed in this Chapter. These issues include selection criteria, dealing with long waits for transplant, the anxiety of where to list and rule changes in allocation of organs. Hopefully with advances in areas such as xeno-transplantation, artificial organs, islet cell transplants, split livers and increased donor registration some of the issues discussed here will become relatively mute, much as risk/ benefit data has made transplantation decisions relatively easy for patients and physicians in recent years. This Chapter will be divided into 1) what transplant personnel should know about the general psychosocial care of transplantation patients; 2) the role of mental health specialists in transplant; 3) specific issues regarding liver, small bowel, kidney, pancreas, heart and lung transplants.

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