Palliative Care in the Adult Solid Organ Transplant Recipient

Palliative care as a routine part of care for solid organ transplant recipients has been recommended to support patients and their caregivers. Palliative care focuses on quality of life for patients with serious illness and their families. Solid organ transplant recipients can have significant morbidity and mortality. When they present to the outpatient clinic, it may be an opportunity for the primary care provider to incorporate primary palliative care interventions into their medical care. Palliative care interventions can be provided regardless of prognosis or types of treatments a patient is receiving and have been associated with improvements in patient quality of life, symptom burden, advance care planning, patient and caregiver satisfaction, and healthcare utilization. Advance care planning can help align patients’ medical care with their individual goals and values, which are important to both document and reassess with major changes in health, such as after solid organ transplantation. Patients may continue to experience symptoms after transplantation as a result of surgery, immunosuppressive medications, or continued organ dysfunction. Referral to a palliative care specialist may be needed in cases of refractory symptoms, worsening health status, cognitive decline, approaching end of life, or challenging decision-making when considering high-risk procedures.