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Many organ transplant recipients experience organ rejection because they are noncompliant with the requirements of the health care regimen. The advanced practice nurse is in an ideal position to assess predictors of noncompliance as well as to implement interventions to enhance patient compliance. The purpose of this paper is to present a case study of a young female heart transplant recipient whose death due to organ rejection was related to noncompliance. The role of the advanced practice nurse in reducing noncompliance is identified and relevant nursing interventions are discussed., (Copyright 2003 CHF, Inc.)

This article describes the role of the advanced practice nurse in the field of cardiac transplantation. A brief review of the history of cardiac transplantation is presented. The role of advanced practice nursing is evolving and changing to meet patients' needs in an increasingly complex health care environment. The advanced practice nurse is uniquely qualified to meet those needs in a variety of roles and settings. The advanced practice nurse maybe a clinical nurse specialist, nurse practitioner, nurse mid-wife, or nurse anesthetist. Each role must include the element of clinical practice in order to be considered advanced practice nurse described in this article. The advanced practice nurse was a clinical nurse specialist in the role of cardiac transplant coordinator. This role comprises the sub-roles of educator, clinician, consultant, researcher, and administrator. The responsibilities and challenges of each sub-role are discussed. Suggestions for the direction of future practice are also presented.

Pediatric cardiac transplantation has profound medical, social, psychological and economic consequences. Parents need to understand both the medical and non-medical consequences of the transplant procedure to make a judicious decision about this treatment. The purpose of this study was to determine the parental understanding of the multiple consequences of transplantation. A prospective ethnographic method was used to study 24 parents of 15 children prior to their decision to accept or reject the transplant option for their children. Findings revealed that the medical consequences of transplantation were well addressed by the pediatric cardiac transplant team. Little attention, however, was given to the non-medical concerns of the parents. The importance of nursing interventions related to information clarification and support for parents as they make decisions about heart transplantation for their children was identified.

Heart transplantation is an effective treatment for end-stage cardiac disease and a major stressor to patients and their families. The purpose of this paper is to review the literature on patient and family adjustment to heart transplantation during the stages from pre-transplantation to post-transplantation. Most authors indicate that patients and families adjust well to heart transplantation. Support groups are a positive resource for heart transplant patients and their families.