Post-transplant psychosocial and mental health care of the lung recipient

Abstract

Patients with advanced lung disease and undergoing lung transplantation have increased rates of depression, anxiety, and cognitive dysfunction. After the lung transplantation, although the quality of life improves, depression and anxiety remain. Depression after lung transplantation has been demonstrated to worsen graft survival, increase risk of chronic rejection, and decrease patient survival. On the other hand, post-transplant anxiety, although distressing, has not been shown to be related to worsened clinical outcomes. Delirium post-lung transplantation occurs in approximately one third of patients and is linked to worse morbidity. Some patients also experience persistent cognitive dysfunction. Patients with shorter time of abstinence from tobacco, patients with chronic obstructive pulmonary disease, and patients surrounded by those who smoke are at increased risk to relapse on tobacco use. Nonadherence is associated with worse clinical outcomes, and it is important to understand its multifactorial nature and to provide evidence-based interventions. This chapter discusses existing literature on post-lung transplant cognitive, anxiety, mood, and tobacco use disorders, as well as adherence and quality of life. This chapter provides some guidance on management and suggests future areas for research.