Klapheke M M
Jewish Hospital Transplant Center, Louisville, Kentucky, USA.
Bull Menninger Clin. 1999 Winter;63(1):13-39.
The psychiatrist has multiple roles on the transplant team, beginning with the transplantation psychiatry consultation (TPC). It addresses such issues as risks of exacerbation or recurrence of a psychiatric illness, pharmacokinetic and pharmacodynamic considerations due to organ failure, potential drug interactions involving psychotropic and immunosuppressant medications, adequacy of support system, history of medical compliance, emotional and cognitive preparedness for transplantation, mental status findings supplemented by standardized cognitive testing and psychosocial rating instruments, and decision-making capacity. The consultation concludes with an overall assessment of the patient's psychosocial strengths and limitations, and recommended interventions to optimize his or her candidacy for transplantation. The consultation findings aid the psychiatrist and the transplant team in striving for fairness and the ideal of "neutrality" in an effort to serve the needs of the patient, other transplant candidates, and society with regard to optimal organ stewardship.
精神科医生在移植团队中扮演多种角色，首先是进行移植精神科会诊（TPC）。会诊涉及诸多问题，如精神疾病加重或复发的风险、器官衰竭导致的药代动力学和药效学考量、精神药物与免疫抑制剂之间潜在的药物相互作用、支持系统的充分性、医疗依从性病史、移植的情绪和认知准备情况、通过标准化认知测试和社会心理评定工具补充的精神状态检查结果以及决策能力。会诊最后会对患者的社会心理优势和局限进行全面评估，并提出优化其移植候选资格的推荐干预措施。会诊结果有助于精神科医生和移植团队努力实现公平以及“中立”的理想状态，以便在最佳器官管理方面满足患者、其他移植候选者以及社会的需求。
