Heart transplantation is more than the mere exchange of an organ that no longer functions. Losing one’s own heart and having to accept one, to ensure survival, from a brain-dead donor constitutes a threat to one’s physical and psychological integrity and demands a high degree of coping skills from the patient. In the present chapter, the phases of the transplantation process as well as their psychological correlates are examined in terms of their meaning for the patient and the patient’s spouse or partner: evaluation, the waiting period for a donor heart, time spent in hospital, the first postoperative year, and long-term survival. Additionally, as many patients receive ventricular assist devices (VAD) (external pumps to aid a failing heart) as a bridge to transplantation, information is provided on how to handle the psychosocial aspects of living with such a life-saving device.
Chronic cardiac insufficiency reduces the affected patients’ quality of life much more than many other chronic illnesses. If, despite all types of therapeutic efforts, the advancing illness and thus the threat to human life and to the quality of life (increasing limitation of living space, physical susceptibility, decreasing endurance, occurrence of psychiatric comorbidities such as depression, compromising of sexuality and partnership) cannot be impeded, for some decades now, this downward spiral no longer ends, as it once did, necessarily with the death of the patient, but rather first by considering a heart transplant. The decision to undergo transplantation is a difficult one, both from the side of the doctors as well as that of the patient. “Heart transplantation is a process that continues for the remainder of the recipient’s life,” warns Peter Shapiro, one of the most experienced psychiatrists from the area of transplantation psychiatry (Shapiro, 1990).
Heart Transplantation Left Ventricular Assist Device Ventricular Assist Device Donor Heart Transplant Team
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This chapter was translated from German by Charlotte Eckler.
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