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Palliative care in cardiopulmonary transplantation
  1. Maria McKenna and
  2. Stephen C Clark
  1. Freeman Hospital, Newcastle, UK
  1. Correspondence to Dr Maria McKenna, Consultant in Palliative Medicine, Freeman Hospital, Newcastle NE7 7DN, UK; maria.mckenna{at}nuth.nhs.uk

Abstract

Cardiopulmonary transplantation is a life-prolonging therapy available to a select population of patients with cardiac or respiratory failure. Transplantation is associated with significant morbidity, mortality and unmet palliative care need. Despite recommendations that palliative care should be a core component of the heart and lung transplant process, collaboration within clinical practice is extremely rare. A key reason for this is the misperception among patients, their families and transplant clinicians, that palliative care is analogous with end of life care. Other challenges include prognostication, communication, and the balance of hope and reality. We suggest a change in clinical practice within cardiopulmonary transplantation, whereby palliative care takes place alongside active management. Greater partnership working will demonstrate clinical credibility and highlight the impact of palliative care interventions. Education is required to address current misperceptions and further research should explore the effect of initiatives to improve palliative care provision for this patient group.

  • Heart failure
  • Respiratory conditions
  • Heart transplantation
  • Lung transplantation
  • Quality of life
  • Palliative care
  • Received 29 July 2014.
  • Revision received 13 December 2014.
  • Accepted 9 March 2015.

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