The 2018 ISHLT/APM/AST/ICCAC/STSW Recommendations for the Psychosocial Evaluation of Adult Cardiothoracic Transplant Candidates and Candidates for Long-Term Mechanical Circulatory Support

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Published 27 April 2018

Mary Amanda Dew, PhD; Andrea F. DiMartini, MD; Fabienne Dobbels, PhD; Kathleen L. Grady, PhD, RN; Sheila G. Jowsey-Gregoire, MD; Annemarie Kaan, MCN, RN; Kay Kendall, MSW, LISW; Quincy-Robyn Young, PhD; Susan E. Abbey, MD; Zeeshan Butt, PhD; Catherine C. Crone, MD; Sabina De Geest, PhD, RN; Christina T. Doligalski, PharmD; Christiane Kugler, PhD; Laurie McDonald, MSW; Linda Ohler, MSN; Liz Painter, MA, MSc; Michael G. Petty, PhD, RN, CNS; Desiree Robson, BSc, RN; Thomas Schlöglhofer, BSc; Terry D. Schneekloth, MD; Jonathan P. Singer, MD, MS; Patrick J. Smith, PhD, MPH; Heike Spaderna, PhD; Jeffrey J. Teuteberg, MD; Roger D. Yusen, MD, MPH; Paula C. Zimbrean, MD

J Heart Lung Transplant. Jul 2018;37(7):803-23

  • Advanced Heart Failure & Transplantation
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ISHLTAcademy of Psychosomatic Medicine (APM)American Society of Transplantation (AST) LogoInternational Consortium of Circulatory Assist Clinicians (ICCAC)Society for Transplant Social Workers (STSW)

Candidates for heart transplantation, lung transplantation, and long-term mechanical circulatory support (MCS) undergo a multifaceted assessment process. The psychosocial evaluation is integral to this process for several reasons. First, it provides information relevant for the selection of patients for transplantation and MCS. Second, it enables care planning and the provision of interventions to improve patients’ viability as transplant and/or MCS candidates. Third, it facilitates referrals for care for patients deemed ineligible for transplantation or MCS. Fourth, for patients who undergo transplantation or device implantation (either as a bridge to transplantation or as permanent, “destination,” therapy), information from the psychosocial evaluation facilitates post-transplantation/post-implantation care to support optimal psychosocial and medical outcomes.

The International Society for Heart and Lung Transplantation (ISHLT), leading a collaboration with the Academy of Psychosomatic Medicine (APM), American Society of Transplantation (AST), International Consortium of Circulatory Assist Clinicians (ICCAC), and Society for Transplant Social Workers (STSW), convened a Writing Committee of international experts to produce this consensus document, which provides recommendations for: (a) the content of the psychosocial evaluation; and (b) the process of evaluation performance, reporting, and use by transplantation and MCS programs. The primary aim of the recommendations is to aid programs to construct evaluation protocols that comprehensively gather information on psychosocial factors recognized in ISHLT guidelines and consensus statements, and/or in the empirical literature as relevant to patient selection for transplantation or long-term MCS implantation. In addition, when psychosocial contraindications for selection are identified, the recommendations outline the implementation of referrals for treatments or interventions that may improve patients’ well-being and suitability as transplantation or MCS candidates.

This document is also available en Español.

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