Key Stressors in Transplant Psychiatry

August 26, 2020

Paula Zimbrean, MD , Catherine Crone, MD , Yelizaveta Sher, MD , Mary Amanda Dew, PhD , Andrea DiMartini, MD , Academy of Psychosomatic Medicine

Here: A summary of indicators for stress and anxiety in patients undergoing transplantation, and why it is important for psychiatrists to be aware of these factors.

Transplantation is the accepted treatment for many patients with chronic or acute advanced organ disease and certain types of cancer. Currently, there are over 120,000 patients in the US waiting for solid organ transplant (nearly 100,000 are kidney transplant candidates), and the wait list continues to grow. Scroll through the slides for key factors psychiatrists need to know.

Potential medical and psychosocial stresses inherent in each phase of transplant.

Adaptation to losses in function

Concerns over acceptance for or survival to treatment, financial strain/loss of work/disability, and even fear of death underscore the need to be aware of the patient experience as they face chronic illness.

During the perioperative phase, patients may experience a sense of elation or a “honeymoon period” that is quickly replaced by fears such as organ rejection, adverse effects of medicine, and other issues.

Soon after treatment and into the first year, patients undergo an adjustment period as they begin to recognize either frustration over the length of time to recover or general limitations of treatment. The recovery process can be more extensive than originally believed. Such feelings can compromise the healing process.

In the years after transplantation, patients encounter and cope with stress related to adjusting to new patterns of living and bearing with a “new normal” that their life has become. Patients have growing concerns over future health issues or financial issues associated with medications and clinical treatments.

For more on this topic, see: Transplant Psychiatry: An Introduction, Part 1, on which this slideshow is based.