Liver Transplantation in a Patient at Psychosocial Risk

Abstract

Psychosocial assessment of transplant candidates is a challenging task. Securing adequate information is made more difficult when patients present with fulminant hepatic failure. When the patient cannot be interviewed and the family is reluctant to provide vital information, a comprehensive pretransplant psychosocial evaluation is virtually impossible. However, even the most difficult cases have the potential for a positive result when a good psychosocial profile of the patient is obtained after transplantation, a team treatment plan is developed and carried out which addresses current and anticipated problems, and the patient obtains mental health treatment.

Electronic Psychosocial Evaluation Tool: Use in a Living Donor Organ Transplant Program

“…Other noted but unexpected returns included the detailed content helping to heigh ten aware ness of complex issues in living donation. [1][2][16][17][18][19][20][21] Visibility of social work staff has been enhanced with this provision of a body of work reliably provided and found to be helpful to other healthcare professionals. Also, the tool has provided a learning instru ment for new social work staff, requiring focus on vital areas of assessment.…”

Letters to the Editor

“…In our experience, it is not the presence of personality disorders, but the patient's commitment (or lack thereof) to psychological treatment that was the best determinant of outcomes. 2 Although the team had some success, we were unable to impact the patient's noncompliance and self-medication; this behavior resulted in the patient's premature death. Unfortunately, the team's posttransplant efforts were not successful in helping the patient to become more aware of her personality problems, develop adequate coping strategies, and appreciate the importance of psychological treatment.…”