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The Approach to the Psychosocial Evaluation of Cardiac Transplant and Mechanical Circulatory Support Candidates

  • Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise (A Hasan, Section Editor)
  • Published:
Current Heart Failure Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

We update evidence underlying the recommendations of a 2018 multi-society consensus report regarding the psychosocial evaluation of individuals for cardiothoracic transplantation and mechanical circulatory support (MCS). In the present review, we focus on heart transplantation and MCS.

Recent Findings

Expert opinion and new evidence support the inclusion of ten core content areas in the psychosocial evaluation. Prospective data indicate that psychosocial factors can predict post-transplantation/post-implantation outcomes. Such factors include treatment adherence history, mental health and substance use history, cognitive impairment, knowledge about treatment options, and social factors such as socioeconomic status. For other factors (e.g., co**, social support), new evidence is weaker because it derives largely from cross-sectional studies. Concerning evaluation process issues, expert opinion remains consistent with consensus recommendations, but there is a dearth of empirical evidence.

Summary

The psychosocial evaluation can identify factors relevant for candidacy for heart transplantation and MCS implantation. It enables the provision of interventions to improve patients’ viability as candidates, and facilitates care planning.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Pittsburgh School of Medicine and Medical Center, 3811 O’Hara Street, Pittsburgh, PA, 15213, USA

    Mary Amanda Dew & Andrea F. DiMartini

  2. Katholieke Universiteit Leuven, Leuven, Belgium

    Fabienne Dobbels

  3. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Kathleen L. Grady

  4. Mayo Clinic, Rochester, MN, USA

    Sheila G. Jowsey-Gregoire

  5. St. Paul’s Hospital, Vancouver, BC, Canada

    Annemarie Kaan & Quincy-Robyn Young

  6. Cleveland Clinic, Cleveland, OH, USA

    Kay Kendall

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  1. Mary Amanda Dew
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  2. Andrea F. DiMartini
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  3. Fabienne Dobbels
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  4. Kathleen L. Grady
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Correspondence to Mary Amanda Dew.

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Conflict of Interest

Mary Amanda Dew’s effort in preparing this report was supported in part by grant R01 AG047416 from the National Institute on Aging, Rockville, MD. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Kathleen L. Grady has been a speaker for the American Heart Association and the Heart Failure Society of America. She and Annemarie Kaan are members of the Board of Directors, ISHLT. All of the authors were members of the leadership group of the 2018 consensus document [1••].

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Dew, M.A., DiMartini, A.F., Dobbels, F. et al. The Approach to the Psychosocial Evaluation of Cardiac Transplant and Mechanical Circulatory Support Candidates. Curr Heart Fail Rep 16, 201–211 (2019). https://doi.org/10.1007/s11897-019-00443-0

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