Psychosocial evaluation of organ transplant candidates. A comparative survey of process, criteria, and outcomes in heart, liver, and kidney transplantation.

Psychosocial selection criteria are widely used by transplant programs but have not been systematically described or compared within or across transplantation type. The authors surveyed all active cardiac, liver, and renal transplant programs in the United States about the existence of psychosocial selection criteria, how and by whom patients were evaluated, weight given to specific criteria, and how often patients were rejected for surgery on psychosocial grounds. The results document important differences in the process, criteria, and outcomes of pretransplant psychosocial evaluation within and across these programs. Cardiac programs are the most stringent, both in criteria and in rate of refusals.