Anil Kumar B N, Mattoo Surendra Kumar
Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian J Med Res. 2015 Apr;141(4):408-16. doi: 10.4103/0971-5916.159268.
Organ transplantation has emerged as the saving grace for those who are suffering from end organ disease. Advent of modern surgical procedures and immunosuppressants further decrease morbidity and mortality. Meta-analyses have shown that post-organ transplantation quality of life improves for social, physical and daily activity functioning, but not consistently for psychological health. Psychiatrists can play a useful role not only in selecting the best suitable candidate for the procedure by psychosocial screening but also to tackle post-operation psychological issues that trouble patients as well as caretakers and decrease their quality of life. Issues like selection of patients with psychiatric disorders and substance abuse for transplantation process and their treatment both pre- and post- operation, risky health behaviours, treatment adherence for immunosuppressants and psychological support for caretakers can be better addressed by a psychiatrist who is sensitive towards these issues. Prescribing various psychotropics and immunosuppressants in the background of impaired organ function and drug-drug interaction is further challenging. Thus, psychiatrists need to be knowledgeable about these issues and should be an integral part of organ transplantation team for overall better outcome.
器官移植已成为终末期器官疾病患者的救命稻草。现代外科手术和免疫抑制剂的出现进一步降低了发病率和死亡率。荟萃分析表明，器官移植后，患者在社交、身体和日常活动功能方面的生活质量有所改善，但心理健康方面的改善并不一致。精神科医生不仅可以通过社会心理筛查为该手术挑选最合适的候选人，还能解决困扰患者及其护理人员并降低其生活质量的术后心理问题。对于患有精神疾病和药物滥用的患者在移植过程中的选择及其术前和术后的治疗、危险的健康行为、免疫抑制剂的治疗依从性以及对护理人员的心理支持等问题，对这些问题敏感的精神科医生能够更好地加以解决。在器官功能受损和药物相互作用的背景下开具各种精神药物和免疫抑制剂更具挑战性。因此，精神科医生需要了解这些问题，并且应该成为器官移植团队不可或缺的一部分，以实现更好的整体治疗效果。
