Phipps L
Allan Memorial Institute, Montreal, Quebec.
Can J Psychiatry. 1991 Oct;36(8):563-8. doi: 10.1177/070674379103600803.
Psychiatrists have been an integral part of the heart transplant team at the Royal Victoria Hospital in Montreal since the program was set up in September 1984. One hundred and twenty five candidates were evaluated for the operation; 12 were found to be unsuitable for surgery because of psychiatric illness. Heart transplant recipients who had previously suffered from a psychiatric disorder fared worse than those who had not. The psychiatrist's recommendations for or against surgery depended on the patient's ability to cope with a number of stressors, including compliance with the medical regimen, waiting for a donor, the surgical procedure itself, adaptation to life with a new organ, and the resolution of a distressing emotional state. Post-operative complications ranged from organic mental syndromes to depression. With the increase in heart transplantations, the competition for organ donors is intensifying and patient selection requires greater involvement of psychiatrists.
自1984年9月蒙特利尔皇家维多利亚医院设立心脏移植项目以来，精神科医生一直是该项目团队的重要组成部分。125名心脏移植候选人接受了手术评估，其中12人因精神疾病被判定不适宜手术。曾患精神疾病的心脏移植受者比未患精神疾病的受者情况更糟。精神科医生对手术的支持或反对建议取决于患者应对多种压力源的能力，这些压力源包括遵守医疗方案、等待器官捐赠者、手术本身、适应新器官后的生活以及缓解痛苦的情绪状态。术后并发症包括器质性精神综合征和抑郁症。随着心脏移植手术数量的增加，器官捐赠者的竞争日益激烈，患者选择需要精神科医生更多地参与。
