Palliative Care in Solid Organ Transplantation

Betty R. Ferrell, PhD, RN


December 08, 2015

Case Presentation: A Patient Awaiting a Lung Transplant

Clare is a 50-year-old school teacher, now disabled owing to idiopathic pulmonary fibrosis. Despite aggressive disease management in the preceding 2 years since her diagnosis, her condition has declined significantly over the past 6 months with decreased function and increased fatigue, dyspnea, and hospitalizations for respiratory infections. Two recent acute crises have resulted in the need for mechanical ventilation and extracorporeal membrane oxygenation.

Clare was placed on the lung transplant waiting list 6 months ago; and despite her declining status, she remains very hopeful that she will receive an organ. She expresses her strong faith as a Catholic, her belief in miracles, her desire to return to her teaching position in a low-income public school, and her need to regain her health to care for her 30-year-old disabled son. She is currently hospitalized for dyspnea, fatigue, and arrhythmia. On medical rounds this morning, a pulmonary resident who is new to the transplant service asks whether Clare should be referred for a palliative care consultation.


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