Outcomes of lung transplant candidates referred for co-management by palliative care: A retrospective case series

Colman, Rebecca E.; Singer, Lianne G.; Barua, Reeta; Downar, James

doi:10.1177/0269216314566839

Cited by 47 publications

(67 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior studies among candidates for other kinds of solid organ transplant suggest that patients generally welcome the opportunity to receive palliative care services and engage in ACP while planning for transplant. 13,[30][31][32][33]42 However, there may be unique challenges to integrating ACP with care processes related to kidney transplant. Existing qualitative work suggests that an emphasis on preventative and curative interventions during the evaluation can sometimes undermine other care processes, 43,44 particularly if these seem inconsistent with the goal of receiving a transplant.…”

Section: Discussionmentioning

confidence: 99%

End-of-Life Care among US Adults with ESKD Who Were Waitlisted or Received a Kidney Transplant, 2005–2014

Butler

Reese

Perkins

et al. 2020

JASN

View full text Add to dashboard Cite

BackgroundThe care of patients in the United States who have ESKD is often shaped by their hopes and prognostic expectations related to kidney transplant. Little is known about how patients’ engagement in the transplant process might relate to patterns of end-of-life care.MethodsWe compared six measures of intensity of end-of-life care among adults in the United States with ESKD who died between 2005 and 2014 after experiencing differing exposure to the kidney transplant process.ResultsOf 567,832 decedents with ESKD, 27,633 (5%) had a functioning kidney transplant at the time of death, 14,653 (3%) had a failed transplant, 16,490 (3%) had been removed from the deceased donor waitlist, 17,010 (3%) were inactive on the waitlist, 11,529 (2%) were active on the waitlist, and 480,517 (85%) had never been waitlisted for or received a transplant (reference group). In adjusted analyses, compared with the reference group, patients exposed to the transplant process were significantly more likely to have been admitted to an intensive care unit and to have received an intensive procedure in the last 30 days of life; they were also significantly more likely to have died in the hospital. Those who died on the transplant waitlist were also less likely than those in the reference group to have been enrolled in hospice and to have discontinued dialysis before death.ConclusionsPatients who had engaged in the kidney transplant process received more intensive patterns of end-of-life care than other patients with ESKD. These findings support the relevance of advance care planning, even for this relatively healthy segment of the ESKD population.

show abstract

Section: Discussionmentioning

confidence: 99%

End-of-Life Care among US Adults with ESKD Who Were Waitlisted or Received a Kidney Transplant, 2005–2014

Butler

Reese

Perkins

et al. 2020

JASN

View full text Add to dashboard Cite

show abstract

“…A palliative care referral for opioid administration may be beneficial to assist with symptom control of dyspnea, cough and other symptoms that may impact on exercise ability and quality of life. A study at our center observed a trend towards increased caloric expenditure during exercise training in 64 lung transplant candidates referred to palliative care post opioid initiation[ 55 ].…”

Section: General Principles Of Exercise Trainingmentioning

confidence: 99%

Physical rehabilitation for lung transplant candidates and recipients: An evidence-informed clinical approach

Wickerson¹,

Rozenberg²,

Janaudis-Ferreira³

et al. 2016

WJT

Self Cite

102

View full text Add to dashboard Cite

Physical rehabilitation of lung transplant candidates and recipients plays an important in optimizing physical function prior to transplant and facilitating recovery of function post-transplant. As medical and surgical interventions in lung transplantation have evolved over time, there has been a demographic shift of individuals undergoing lung transplantation including older individuals, those with multiple co-morbidites, and candidates with respiratory failure requiring bridging to transplantation. These changes have an impact on the rehabilitation needs of lung transplant candidates and recipients. This review provides a practical approach to rehabilitation based on research and clinical practice at our transplant centre. It focuses on functional assessment and exercise prescription during an uncomplicated and complicated clinical course in the pre-transplant, early and late post-transplant periods. The target audience includes clinicians involved in pre- and post-transplant patient care and rehabilitation researchers.

show abstract

“…These 29 articles were similarly reviewed, and 7 articles were included in the final sample. [15][16][17][18][19][20][21]…”

Section: Resultsmentioning

confidence: 99%

“…Study designs included 5 quantitative [15][16][17][18][19] and 2 qualitative studies. 20,21 Four of the quantitative studies were retrospective cohort studies [15][16][17]19 and 1 was a cross-sectional survey. 18 One qualitative study involved interviews with individuals, and the other used a mix of individual interviews and focus group methodology.…”

Section: Study Designsmentioning

confidence: 99%

An Integrative Review of the Role of Palliative Care in Lung Transplantation

et al. 2020

View full text Add to dashboard Cite

Background: Lung transplant patients experience significant physical symptoms and psychological stress that affect their quality of life. Palliative care is an interdisciplinary specialty associated with improved symptom management and enhanced quality of life. Little, however, is known about the palliative care needs of lung transplant patients and the role it plays in their care. Aim: The aim of this integrative review was to synthesize the literature describing the palliative care needs, the current role, and factors influencing the integration of palliative care in the care of lung transplant patients. Design/Data Sources: We searched PubMed, Scopus, CINAHL, and Embase to identify English-language, primary studies focused on palliative care in adult lung transplantation. Study quality was evaluated using Strengthening the Report of Observational studies in Epidemiology and Consolidated Criteria for Reporting Qualitative Research criteria. Results: Seven articles were included in the review. Most were single-center, descriptive studies. Two studies used qualitative and 5 used quantitative methodologies. Collectively, these studies suggest that palliative care is typically consulted for physical and psychological symptom management, although consultation is uncommon and often occurs late in the lung transplant process. We found no studies that systematically assessed palliative needs. Misperceptions about palliative care, communication challenges, and unrealistic patient/family expectations are identified barriers to the integration. While limited, evidence suggests that palliative care can be successfully integrated into lung transplant patient management. Conclusions: Empirical literature about palliative care in lung transplantation is sparse. Further research is needed to define the needs and opportunities for integration into the care of these patients.

show abstract

Outcomes of lung transplant candidates referred for co-management by palliative care: A retrospective case series

Abstract: In lung transplant candidates, palliative care and opioids in particular can be safely provided without compromising eligibility for transplantation. Palliative care should not be delayed until a patient is deemed ineligible for transplant.

Cited by 47 publications

References 34 publications

End-of-Life Care among US Adults with ESKD Who Were Waitlisted or Received a Kidney Transplant, 2005–2014

End-of-Life Care among US Adults with ESKD Who Were Waitlisted or Received a Kidney Transplant, 2005–2014

Physical rehabilitation for lung transplant candidates and recipients: An evidence-informed clinical approach

An Integrative Review of the Role of Palliative Care in Lung Transplantation

Contact Info

Product

Resources

About