Abstract
Lung transplantation is a life-prolonging therapy available to a select population of patients with respiratory failure. Transplantation is associated with significant morbidity, mortality and palliative care need. Common symptoms throughout the lung transplant journey include breathlessness, cough, fatigue, anxiety and depression. Challenges include prognostication with an uncertain and unpredictable disease trajectory, balancing hope and practicality, and the misperception amongst patients, families and transplant clinicians that palliative care is analogous with end-of-life care. An integrated model is suggested within lung transplantation, whereby palliative care takes place alongside active management by the transplant team. This concurrent approach should involve explicit acknowledgement regarding the presence of advanced disease and possibility of death, whilst hoping that a donor organ may become available for transplant before surgery becomes futile. End-of-life care is also crucial in those recipients whose post-operative course is complicated by potentially fatal complications. Close collaboration between transplant services and palliative care teams is essential to achieve optimal holistic and palliative care. This will become more important with the use of new technologies such as extracorporeal membrane oxygenation (ECMO) to bridge critically ill patients to transplantation.
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McKenna, M., Clark, S.C. (2019). Lung Transplantation. In: Bourke, S., Peel, T. (eds) Integrated Palliative Care of Respiratory Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-18944-0_13
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DOI: https://doi.org/10.1007/978-3-030-18944-0_13
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