Mismatch identified in symptom burden profiles in lung transplantation

Koons, Brittany; Aryal, Subhash; Blumenthal, Nancy P.; Courtwright, Andrew; O’Connor, Melissa; Christie, Jason D.; Singer, Jonathan P.; Riegel, Bárbara

doi:10.1016/j.hrtlng.2023.02.011

Cited by 2 publications

(3 citation statements)

References 29 publications

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“…The NYHA grade is in good agreement with the quality of life of patients with IPF and the distance that the patient walks in six minutes [ 21 , 22 ]. According to recent research, the patient's perception of quality of life and the results of objective examinations do not correlate in approximately one-third of patients [ 23 ]. The authors of the research justify this discrepancy by the probable influence of the so-called social determinants of health, i.e., the conditions in which the patient was born, grew up, lived, worked, and aged [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Adherence to the ISHLT Protocol for the Referral of Patients with Idiopathic Pulmonary Fibrosis to the Transplantation Center among of Czech Centers for Interstitial Lung Diseases

Sterclova,

Doubkova,

Sykorova

et al. 2024

Pulmonary Medicine

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There are limited data on referral rates and the number of patients with idiopathic pulmonary fibrosis (IPF) who are eligible for lung transplantation. The aim of the present study was to assess adherence to the consensus of the International Society for Heart and Lung Transplantation (ISHLT) for the referral of patients with IPF among Czech interstitial lung disease (ILD) centers. Czech patients who were diagnosed with IPF between 1999 and 2021 (n = 1584) and who were less than 65 years old at the time of diagnosis were retrospectively selected from the Czech Republic of the European Multipartner Idiopathic Pulmonary Fibrosis Registry (EMPIRE). Nonsmokers and ex‐smokers with a body mass index (BMI) of <32 kg/m2 (n = 404) were included for further analyses. Patients with a history of cancer <5 years from the time of IPF diagnosis, patients with alcohol abuse, and patients with an accumulation of vascular comorbidities were excluded. The trajectory of individual patients was verified at the relevant ILD center. From the database of transplant patients (1999‐12/2021, n = 541), all patients who underwent transplantation for pulmonary fibrosis (n = 186) were selected, and the diagnosis of IPF was subsequently verified from the patient’s medical records (n = 67). A total of 304 IPF patients were eligible for lung transplantation. Ninety‐six patients were referred to the transplant center, 50% (n = 49) of whom were referred for lung transplantation. Thirty percent of potentially eligible patients not referred to the transplant center were considered to have too many comorbidities by the reporting physician, 19% of IPF patients denied lung transplantation, and 17% were not referred due to age. Among Czech patients with IPF, there may be a larger pool of potential lung transplant candidates than has been reported to the transplant center to date.

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Section: Discussionmentioning

confidence: 99%

Adherence to the ISHLT Protocol for the Referral of Patients with Idiopathic Pulmonary Fibrosis to the Transplantation Center among of Czech Centers for Interstitial Lung Diseases

Sterclova,

Doubkova,

Sykorova

et al. 2024

Pulmonary Medicine

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“…Thus, the literature on PC effects in the advanced lung disease and transplant populations has been mixed [17 ▪▪ ,18,19 ▪▪ ]. Further, evidence demonstrates that symptoms in LTx candidates can be heterogeneous and do not always reflect objective measures of illness severity [20 ▪ ], often a trigger for referral to PC, especially in those who are younger, more racially diverse, and have higher psychosocial risk factors [39 ▪ ].…”

Section: Palliative Care Management Strategiesmentioning

confidence: 99%

“…Although trigger tools have faced criticism for their perceived inability to identify PC needs accurately [57], specifically, matching the right patient with the appropriate timing, there is potential to develop triggers for PC referral. For instance, these triggers could be activated when a patient experiences deterioration, either subjectively or as indicated by patient-reported outcome measures or physiological assessments such as the 6MWT, or when they undergo admission or are declined for transplant [26,39 ▪ ].…”

Section: Palliative Care Management Modelsmentioning

confidence: 99%

An update of palliative care in lung transplantation with a focus on symptoms, quality of life and functional outcomes

Rozenberg,

Andrawes,

Wentlandt

2024

Current Opinion in Pulmonary Medicine

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Purpose of review Palliative care (PC) in lung transplantation is increasingly acknowledged for its important role in addressing symptoms, enhancing functionality, and facilitating advance care planning for patients, families, and caregivers. The present review provides an update in PC management in lung transplantation. Recent findings Research confirms the effectiveness of PC for patients with advanced lung disease who are undergoing transplantation, showing improvements in symptoms and reduced healthcare utilization. Assessment tools and patient-reported outcome measures for PC are commonly used in lung transplant candidates, revealing discrepancies between symptom severity and objective measures such as exercise capacity. The use of opioids to manage dyspnea and cough in the pretransplant period is deemed safe and does not heighten risks posttransplantation. However, the integration of PC support in managing symptoms and chronic allograft dysfunction in the posttransplant period has not been as well described. Summary Palliative care support should be provided in the pretransplant and select peri-operative and posttransplant periods to help support patient quality of life, symptoms, communication and daily function.

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Mismatch identified in symptom burden profiles in lung transplantation

Cited by 2 publications

References 29 publications

Adherence to the ISHLT Protocol for the Referral of Patients with Idiopathic Pulmonary Fibrosis to the Transplantation Center among of Czech Centers for Interstitial Lung Diseases

Adherence to the ISHLT Protocol for the Referral of Patients with Idiopathic Pulmonary Fibrosis to the Transplantation Center among of Czech Centers for Interstitial Lung Diseases

An update of palliative care in lung transplantation with a focus on symptoms, quality of life and functional outcomes

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