Psychological criteria for contraindication in lung transplant candidates: 5 years survey

Introduction: Lung transplantation presents challenges for the multidisciplinary team in the care of the receptor.A thorough evaluation of candidates is required to ensure the best possible post-transplant outcome, and psychological evaluation is indispensable. Objective: Evaluate the psychological causes of contraindication for waiting list inclusion in a referral program of lung transplantation. Methods: Retrospective analysis of the records of the multidisciplinary meetings from may/2009 to may/2014,assessing specifically the psychological issues. Results: 345 cases were reviewed,51% female- ages ranging from 12 to 67 years.The Psychology Service found contraindication criteria (relative or absolute) in 117 patients (33.91%):chemical dependency for less than 6 months in 4 patients;intellectual limitations associated with lack of adequate social support in 3 patients;inadequate adherence to treatment in 24 patients;lack or absence of caregiver/home support in 43 patients;psychological condition that compromises care (specially depression) in 34 patients;lack of information on disease and transplant procedure in 16 patients;uncertainty regarding the acceptance of transplantation in 11 patients and absolute rejection for transplantation in 14 patients.Of note, some of the patients had more than one complicating factor. Conclusion: Lung transplantation, therefore, presents psychologists with many features for assessment and intervention making psychological evaluation indispensable in the pre operatory evaluation.Our task is to identify problems and avoid undergo high-risk patients to the surgical procedure,allowing more suitable patients to experience the full benefits of their lung transplant.