Psychosocial Evaluation for Lung Transplantation: an Empirically Informed Update

摘要

Purpose of Review This review summarizes the pre-surgical psychosocial evaluation for lung transplant (LT), positioned within an evidence-based practice framework and a biopsychosocial model of phenotypes of risk and resilience. We incorporate updated research pertinent to LT published since the landmark 2018 multi-society consensus document on psychosocial evaluations for cardiothoracic transplant. Recent Findings The conceptualization and recommendations generated from the psychosocial pre-LT evaluation should be based on current evidence and may be enhanced by incorporating biopsychosocial phenotypes of risk and resilience; interventions may target modifiable risks to improve candidacy. Broad evaluation domains with potential to differentially affect outcomes for LT are psychological, behavioral, cognitive, and social/environmental. The psychosocial evaluation is an important component of the multidisciplinary LT candidacy evaluation and may identify areas for optimization prior to LT; psychosocial data should not be treated the same as laboratory-based data in candidacy decision-making, requiring additional context and nuance. Future research should focus on continued examination of psychosocial risk factors including phenotypes and mediators/moderators of risk for LT.