ISSN:1071-2089    

DOI:10.1111/j.1751-9861.1994.tb00035.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

This article provides a review of the current status of cardiac transplantation, which offers the only viable alternative for the management of patients with refractory congestive heart failure. The criteria for recipient evaluation and selection are discussed. The major limitation to the number of potential recipients of cardiac transplantation is the availability of donors, numbering about 2000 per year. The current one‐year survival rate is approximately 80%, while the 5‐year survival rate is in excess of 70%. These numbers confirm the therapeutic benefit derived from cardiac transplantation, and are in marked contrast to the one‐year mortality rate of 30–60% experienced by patients with New York Heart Association class IV congestive heart failure. The long‐term complications of cardiac transplantation include acute and chronic rejection, infection, the side effects of immunosuppressive agents (including nephrotoxicity and hypertension), the development of neoplasms, and accelerated transplant coronary arteriopathy.This paper also emphasizes the areas in which investigation into the behavioral aspects of cardiac transplantation may be directed, including: (a) study of the individual and group attitudes toward organ donation; (b) psychologic implications of mechanical circulatory support as an alternative to cardiac transplantation; (c) in the transplanted patient with a denervated heart there is the opportunity to study the interaction between the autonomic nervous system and behavioral stimuli; (d) the psychologic adaptation of the recipient to organ transplantation; (e) the role of educational programs designed to influence favorably the attitude of the general population toward organ transplantation; and (f) in the future, the psychologic aspects of xenograft transplantation as an alternative to homograft transp

ISSN:1071-2089    

DOI:10.1111/j.1751-9861.1994.tb00036.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The nature and quality of heart recipients' adaptation to transplant must be considered when evaluating the costs of utilizing this procedure. Little is known about the occurrence of clinically significant levels of psychiatric distress or other physical functional and psychosocial limitations in the long‐term following initial recovery. Most important, despite assertions that recipients' well‐being and psychosocial status are critical predictors of their medical compliance and hence, of the ultimate survival, systematic research to document such relationships is lacking. This article summarizes research on quality of life and medical compliance in transplantation, presents a conceptual framework for understanding interrelationships among such variables, and describes early results from a longitudinal study of heart transplant recipients followed during their first year after surgery. Findings indicated that psychological distress and psychosocial status early posttransplant predicted compliance levels in ensuing months; difficulties adhering to the medical regimen were, in turn, related to physical, mental, and social well‐being at subsequent follow‐up. Implications of these patterns of reciprocal effects are considered both for treatment and for refining conceptual models of adaptation to transpla

ISSN:1071-2089    

DOI:10.1111/j.1751-9861.1994.tb00037.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Liver transplantation has become an accepted treatment for many patients with end‐stage cirrhosis. Often, liver transplant candidates have had to cope with alterations in their daily life routines for a number of years prior to transplantation. Both patients and their families may experience stress associated with chronic illness. Although the prospect of a liver transplant may add a dimension of renewed hope for a normal life, new fears regarding outcome usually arise. A mixture of hopes and worries will be apparent during the inpatient stay required for the evaluation of transplant candidacy. This article focuses on the psychiatric and psychosocial assessment of these patients. We also describe interventions to ensure optimal psychosocial care during hospitalizatio

ISSN:1071-2089    

DOI:10.1111/j.1751-9861.1994.tb00038.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY