PURPOSE: Patients under consideration for or who have undergone lung and heart transplantation experience many symptoms, including dyspnea, anxiety, pain and caregiver burden. Integration of palliative care (PC) into the multi-disciplinary care team for patients seeking treatment by transplantation shows promising benefits. Common misconceptions of PC may potentially lead to clinicians omitting palliative care from the multi-disciplinary approach to these complex diseases. This study reviews the literature to identify common misconceptions about PC, its current utilization in lung and cardiac transplantation, ideas for improvement in the integration of transplantation care, and the benefits of PC in the care of pre and post-operative heart or lung transplant recipients.

METHODS: Focused literature review of articles about palliative care in lung and heart transplant by surgery, palliative care, transplant hospitals, and advanced heart and lung disease care teams were used to provide well rounded interpretation of the barriers to and benefits of PC.

RESULTS: Limited studies are available to assess PC impact on lung and heart transplant patients. Of those studies available, there are suggestions that PC improves patient perception of quality of life by reduction in symptoms associated with chronic disease: dyspnea, anxiety, pain, and caregiver burden. This review also identified the common confusion of using the terms palliative care and hospice synonymously. The studies to date underline the importance of further investigation to evaluate PC effectiveness as measured by the patients and caregivers. They also identify a need for patient and clinician education on the differences between PC and end of life care.

CONCLUSION: While studies are small and limited, they suggest that integration of PC with patients who are listed or are recipients of heart or lung transplants may prove to be a beneficial, yet underutilized resource to provide to patients and caregivers, well rounded holistic care along the entire trajectory of chronic illness . The literature also suggest that proper education and dialogue with patients and care teams about the role of PC may allow for early referral and management of symptoms associated with chronic heart and lung disease along the entire transplant continuum.

CITATION INFORMATION: Manfredi A, Toevs C. The Role of Palliative Care in the Thoracic Transplant Multidisciplinary Care Team: Barriers and Benefits. Am J Transplant. 2016;16 (suppl 3).

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