TRANSPLANT PSYCHIATRY: OPPORTUNITIES FOR INNOVATION, INTERVENTION, AND IMPROVED OUTCOMES

Abstract

This Clinical Perspectives session aims to increase general and subspecialty child and adolescent psychiatrists’ awareness and understanding of the field of pediatric transplantation and the critical role they can have in assessing for readiness, strengthening adherence, and improving outcomes. This Clinical Perspectives session will begin with an introduction to pediatric transplantation by Molly Dugan, LCSW (Atlanta, GA). She will highlight the challenges that children and their families experience in transplant listing and psychosocial evaluation. Ms. Dugan will introduce an illustrative case that will unfold throughout each presentation, highlighting each speaker’s expertise and learning objectives, through progressive disclosure. Richard Shaw, MD (Palo Alto, CA), will follow with a presentation on an innovation to structure and strengthen the universal requirements for pretransplant psychosocial assessment and begin initiatives to evaluate the predictive validity of these assessments. Next, Melissa Cousino, PhD (Ann Arbor, MI), will discuss the critical literature and impact of communication and decision making in transplanted youth. Nasuh Malas, MD, MPH (Ann Arbor, MI), will discuss adherence challenges in transplanted youth and the role of motivational interviewing. Kelly Rea (Athens, GA) will discuss the dilemmas of transition evaluation and readiness in youth highlighted by outcomes data in her lab’s research. Finally, Dr. Shaw and Ms. Dugan will reflect on the evolving case, synthesize the speakers’ presentations, and help facilitate questions and answers from the audience on the critical role that psychiatrists and other behavioral health colleagues can have in improving the field of transplant psychiatry and outcomes for youth and families. Child and adolescent psychiatrists work with youth with chronic physical illnesses and who may be evaluated for and potentially need an organ transplant to extend their life. Myriad mental health and psychosocial conditions and determinants can impact acceptance, readiness, experience, and success in transplantation. Child and adolescent psychiatrists are well suited by merit of their full skill set as psychosocial assessors, liaisons, researchers, expert communicators, and interventionists to partner with transplant teams and treat youth to improve transplant outcomes.