Index. Note: Page numbers of article titles are in boldface type. Heart Transplantation

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1 Heart Transplantation Index Note: Page numbers of article titles are in boldface type. Accelerated graft atherosclerosis (AGA), post heart transplantation, Acute rejection, of heart, in adults, 70 in children, of heart transplant, 70 Advocacy, in heart transplantation, 114, 116 conflict with justice, 116 paternalism and, in heart transplantation, 114 AGA. See Accelerated graft atherosclerosis (AGA). Age, heart transplantation and, 39 ethical perspectives in, Allocation, of heart, to status 1 patient, justification forms for, United Network for Organ Sharing in, 7 Allocation of resources, in heart transplantation, 14-20, 113, 117 Angiotensin-converting enzyme (ACE) inhibitors, in status 1 heart transplantation patient, 53 Arrhythmia, in status I patient pretransplant, 56 Atherosclerosis, of cardiac graft, accelerated, peripheral and cerebrovascular, heart transplantation and, 41 Autonomy, in heart transplantation, recipient and, Barnard, Christian, 1, 3, 6 Beneficence, in heart transplantation, family and significant others and, health care providers and, 114, 117 recipient and, Bleeding, perioperative, with left ventricular assist Brain death, effects on hormones, organ procurement and, 25 Brunchweig, Hieronymus, 2 Children, cardiac transplantation in, parental considerations in, clarification of information and support for, during waiting period, ethical, 81 in decision-making period, in disclosure of treatment option information, participation in decision-making and, 80 post transplantation, Chinese medicine, heart transplantation in, 2 Cholelithiasis, heart transplantation and, 41 Chromotrope, in status 1 heart transplantation patient, 53 Congestive heart failure, treatments in, 61 Consent, coroner, in organ procurement, Cost containment, in heart transplantation, case management in, 126 collaborative pathways in, multidisciplinary team pathway in, patient management and, posttransplant, pretransplant, 125 patient recovery plan in, 126, 129 pharmacologic strategies in, 126 variance tracking in, Cost(s), of heart transplantation, 20, estimated, 122 hospitalization, long-term follow-up, patient issues and, status 1 patient care, 122 transplant program issues and, 123 parental, in pediatric heart transplantation, 82 Cyclosporine A, heart transplantation and, 6-7 Cytomegalovirus (CMV) infection, post heart transplantation, 71 Cachexia, heart transplantation and, 43 Cardiac rehabilitation program, pretransplantation, Cardiac transplantation. See Heart transplantation. Carrel, Alexis, 2-4 Demikhov, Vladimir, 3-4 Depression, post heart transplantation, 75 Diabetes mellitus, heart transplantation and, in status 1 patient, insulin-dependent, 41 posttransplant,

2 152 INDEX Disclosure of information, related to treatment options, heart transplantation in children and, Donor organ, evaluation and maintenance of, hemodynamic stabilization in, routine orders in, transmissible disease tests in, Dyslipidemia, post heart transplantation, 73 Economics, of heart transplantation, cost containment strategies and, costs, 20, 82, historical perspectives and, issues in, for patients, 56-57, for transplant programs, 123 Equal opportunity, in heart transplantation, Ethical perspectives, in heart transplantation, advocacy and, 114, 116 age and, autonomy and, beneficence and, , 117 equal opportunity and, ethical principles and, 112 inherited disease and genetic considerations and, justice and, 113, of family and significant other, of health care provider, of recipient, paternalism and, 114 respect for others and, 116 retransplantation and, 117 veracity and, 114-'-115 Exercise tolerance, in heart transplantation evaluation, Faith, in heart transplant patient, Family, in organ donation, postrecovery, 31 request for organ, 31 roles in, post heart transplantation, 75 Fever, post heart transplantation, in children, 83 Follow-up care, in heart transplantation, 69-70, 126 Fungal infection, opportunistic, post heart transplantation, 71 Gibbon, John, 3 Greek myth, heart transplantation in, 1-2 Grieving process, in heart transplant patient, Grounded theory methodology, definition of, 88 in spirituality study, in heart transplant patient, 88 Guilt, of heart transplant recipient, 98 post heart transplantation, 75 Guthrie, Charles Claude, 3 Hardy, James D., 5-6 HCFA. See Health Care Financing Administration (HCFA). Health Care Financing Administration (HCFA), heart transplantation and, for Medicare recipients, 7 organ donation referral policy of, 25 Heart, for transplantation, allocation of, Heart allocation, by geographic area, by patient listing status, status IA justification form in, status lb justification form in, 16 UNOS Regional Review Board and, Appeal Intent Form-1 of, 15, 20 Heart transplantation. See also Transplantation. alternatives to, 36 left ventricular assist device, candidate for, care of, complications of, accelerated graft atherosclerosis, acute rejection, 70 diabetes, hypertension, infection, long-term management of, malignancy, 73 nephrotoxicity, 72 obesity and dyslipidemias, 73 osteoporosis, psychosocial issues, 75 contraindications to and comorbidity assessment in, cost containment strategies in, See also Cost containment, in heart transplantation. costs of, 20, 82, current and future issues in, 7-8 discharge preparation following, 69 disease severity and prognosis evaluation and, exercise tolerance in, hemodynamic parameters in, 37 neurohumoral factors in, 38 New York Heart Association classification in, 37 donor heart for, allocation of, procurement of, economic trends and issues in, for patients, for transplant programs, 123 historical perspectives and, ethical perspectives in, evolution of, 1-9 follow-up and, history of, 1-7 clinical era in, 5-7 experimental era in, 3-5 prehistory in, 1-2 human-to-human, first, 5-6 immunosuppression and, 6-7, 70, , in children. See also Children, cardiac transplantation in. decision-making period for parents, parental needs following, waiting period in, indications for, 36 long-term management in, managed care and, Medicare approval of, 121 pretransplant patient evaluation for, psychosocial criteria for, psychosocial issues and, 75

3 INDEX 153 Heart transplantation (Continued) quality of life before and after, for spouse, of status 1 patient, selection criteria for, spirituality and, status 1 patient and, survival rate in, 69 systemic disease and, waiting period in, parents of pediatric candidate and, waiting time for, 35 HeartMate, first left ventricular assist device, 62 Hemodynamics, in heart transplantation evaluation, 29-30, 37 optimization of, in status 1 heart transplantation patient, 52 Hemorrhage, perioperative, with left ventricular assist Hepatobiliary disease, heart transplantation and, 41 Heterotopic transplantation, 3 Mann technique for, 3-4 Hope, in heart transplant patient, 90, 95, 97 Hospitalization, in heart transplantation, cost of, pretransplant, of status 1 heart transplantation patient, 51, Hypertension, post heart transplantation, in children, 83 IABP. See Intra-aortic balloon pump (IABP). IDDM. See Insulin-dependent diabetes mellitus (JDDM). Immunosuppression, in heart transplantation, 6-7 post heart transplantation, 70 Immunosuppressive drugs, in heart transplantation, 6-7 costs of, , new, 7 Implantable circulatory support, in heart failure, 7-8 Infection, post heart transplantation, prevention and detection of, in status 1 heart transplantation patient, 55 Inotropes, in status 1 heart transplantation patient, Insulin-dependent diabetes mellitus (IDDM), heart transplantation and, 41 Insurance, heart transplantation and, 124 posttransplant, Intra-aortic balloon pump (labp), in status 1 heart transplantation patient, 53 Irradiation, total lymphoid, post heart transplantation, 7 Jalowiec Coping Scale (JCS), for spouse of heart transplant recipient, pre- and post transplantation, , 108 JCS. See jalowiec Coping Scale (]CS). Judaism, ancient, heart transplantation concept in, 2 Justice, in heart transplantation, conflict with advocacy, 116 health care providers and, 115, 117 recipient and, 113 Kantrowitz, Adrian, 6 Kidney failure, in status 1 heart transplantation patient, 54 Left ventricular assist device (LVAD), as bridge to heart transplantation, cardiac remodeling and, 67 complications of, potential, contraindications to, 64 criteria for placement of, current portable, definition of, history of, in status 1 heart transplantation patient, 53 mechanics of, 63 malfunction of, postimplantation operation of, normal values and alarms with, postoperative activity with, 67 psychological needs of patient, family, support people, 67 Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure study of, Legislation, in transplantation, organ procurement and, Liver failure, in status 1 heart transplantation patient, 54 LVAD. See Left ventricular assist device (LVAD). Malignancy, post heart transplantation, 73 pre-heart transplantation, 42 screening for, 42 Mann, Frank C., 3-4 Mechanical assist, in status 1 heart transplantation patient, 53 Mechanical support, permanent cardiac, versus heart transplantation, 7-8 Medicare, approval of heart transplantation, 121 Mental illness, heart transplantation and, 44 Methotrexate, post heart transplantation, 7 Miracles, christian, transplantation as, 2 Nephrotoxicity, post heart transplantation, 72 Neuropsychologic assessment, in heart transplantation evaluation, 44 Nosocomial infection, with left ventricular assist Novacor Left Ventricular Assist System, 62 Nutritional status, optimization of, in status 1 heart transplantation patient, 55 Obesity, morbid, heart transplantation and, post heart transplantation, 73 OKT3, in heart transplantation, 7 OPTN. See Organ Procurement and Transplantation Network (OPTN).

4 154 INDEX Organ donation, apnea test in, 25 brain death in, 25 consent in, contraindications to, coroner consent in, donor family and, options for, postrecovery care of, 31 request for donation and, donor in, identification of, potential, 223 legislation and, organ in, evaluation and maintenance of, 28-29, 223 recovery of, suitability evaluation of, 30 process of, recipient identification in, 30 Organ Procurement and Transplantation Network (OPTN), in heart allocation, 7 in heart transplantation, Organ procurement organization, coroner and, 26 in United Network for Organ Sharing, Organ procurement organizations, in heart transplantation, Organ transplantation, legislation and, Orthotopic transplantation, 3 Osteopenia, in status 1 heart transplantation patient, 54 Osteoporosis, heart transplantation and, 43 in status 1 patient, 54 post heart transplantation, Panel reactive antibodies, heart transplantation and, 43 Paternalism, in heart transplantation, 115 Peripheral vascular disease, in status 1 heart transplantation patient, Physical conditioning, in status 1 heart transplantation patient, Posttransplant diabetes mellitus (PTDM), Psychosocial issues, in heart transplantation, 43-44, 56-57, 75 posttransplant adjustment, 75 pretransplant, status 1 patient and, PIDM. See Posttransplant diabetes mellitus (PTDM). Pulmonary disease, heart transplantation and, Pulmonary hypertension, heart transplantation and, Pump oxygenator, open heart surgery and, 3 QLI. See Quality of Life Index (QLI). Quality of life, definition of, 103 of spouse, pre- and post heart transplantation study of, coping strategies in, , 108 index of, stressors in, 104, 107 of status 1 patient, pretransplant, Quality of Life Index (QLI), for spouse of heart transplant recipient, pre- and post transplantation, Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) study, in nontransplantable patients, Rehn, Ludwig, 3 REMATCH. See Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) study. Renal failure, post heart transplantation, 72 Renal impairment, heart transplantation and, 40 Respect for others, in heart transplantation, 116 Respiratory infection, post heart transplantation, 71 Shumway, Norman, 6 Spirituality, importance of in health maintenance, 87 in heart transplant patient study, assumptions in, 787 central core category in, 89 clinical application of, in interventions, confronting illness in, credibility of findings in, data analysis in, 89 data collection in, developing faith in, discussion in, facing mortality in, grieving process in, grounded theory methodology in, hypothesis generation in, 99 presence in, 91-92, protection of human subjects in, 787 qualitative research in, recovery in, 95 reframing in, 93-94, 97 sustaining hope in, 90, 95, 97 Spouse Transplant Stressor Scale (STSS), pre- and post heart transplantation, 104, 107 Status 1 patient, awaiting donor heart, angiotensin-converting enzyme inhibitors for, 53 arrhythmia management in, 56 chronotropic management of, 53 comorbidity optimization in, education of and preparation for transplantation, financial considerations of, future trends and, 58 hemodynamic optimization of, 52 hospitalization of, 51 infection prevention and detection in, 55 inotropic support of, mechanical assist of, 53 nutritional status optimization in, 55 observation/monitoring of, physical conditioning of, prevention and detection of end-organ damage in, 54 psychosocial issues of, quality of life of, heart allocation to, justification forms for, heart transplantation in, eligibility criteria-recipient status, indications for listing as, pretransplant considerations in, immediate, 58 STSS. See Spouse Transplant Stressor Scale (STSS). Substance abuse, heart transplantation and, 43-44

5 INDEX 155 Thrombus, formation of, with left ventricular assist Tissue-typing laboratory (TTI.), in United Network for Organ Sharing, Transplant programs, economic issues of, 123 Transplantation. See also Heart transplantation. financial aspects of, 20 Transplantation of Veins and Organs, The, 3 TTI.. See Tissue-typing laboratory (TTL). organizational role of, policy and bylaw development in, recipient listing status, for heart transplantation, 14-20, 49-50, 122 United Network for Organ Sharing (UNOS) policy 3.7, heart allocation and, University of Mississippi Medical Center, heart transplantation at, 5 UNOS. See United Network for Organ Sharing (UNOS). United Network for Organ Sharing, in heart transplantation, United Network for Organ Sharing (UNOS), evolution and history of, in heart allocation, 7, membership structure of, mission of, 12 organ procurement organizations in, 14 Veracity, in heart transplantation, health care providers and, Viral infection, post heart transplantation, 71 Xenoses, 7 Xenotransplantation, 7