[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-458864-105":59,"doc-detail-458864-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","early-palliative-care-in-heart-transplant-evaluation","Early Palliative Care in Heart Transplant Evaluation","","Palliative care (PC) is increasingly used for advanced heart failure, yet it is not routinely embedded in heart transplant evaluation. This case report examines a 67-year-old man with ischemic cardiomyopathy on continuous inotropic support who initially declined transplant evaluation and requested immediate discharge. PC clarified prognosis in the absence of advanced heart failure therapies and identified severe claustrophobia as the key barrier. Through targeted psychological and psychiatric support, the patient tolerated the process and completed evaluation, resulting in successful heart transplantation. PC also bridges medical and psychosocial teams by managing symptoms and enabling goal-concordant, patient-centered care.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/early-palliative-care-in-heart-transplant-evaluation/458864/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/early-palliative-care-in-heart-transplant-evaluation/458864.png","ImageObject",300,407,{"name":92,"@type":93},"Blue Pony","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is palliative care important in advanced heart failure and transplant evaluation?","Question",{"text":112,"@type":113},"Palliative care helps alleviate complex symptom burden and supports goal-concordant care. It may identify and manage barriers during transplant evaluation, especially when significant psychopathology is present.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What barrier prevented the patient from completing the transplant evaluation initially?",{"text":117,"@type":113},"Severe claustrophobia drove the patient’s desire to end the transplant evaluation and request immediate hospital discharge.",{"name":119,"@type":110,"acceptedAnswer":120},"How did palliative care contribute to the patient’s successful outcome?",{"text":121,"@type":113},"PC clarified prognosis without advanced heart failure therapies and used effective communication plus psychological and psychiatric support to make the claustrophobia tolerable. The patient then completed the evaluation and underwent successful heart transplantation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458864,1790894729,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090760266,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Received 09/02/2025  \nReview began 10/15/2025  \nReview ended 12/03/2025  \nPublished 12/09/2025  \n© Copyright 2025  \nStringer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98804  \nOpen Access Case Report  \nPublished via Proceedings of the UCLA Department of Medicine  \nEarly Palliative Care in Heart Transplant Evaluation  \nWilliam S. Stringer 1, Alissa A. Ulanday 2 , Christine M. Bui 3, Rachel M. Verhagen 4, Shelley J. Choi 3  \n1. Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA 2. Nursing, University of California Los Angeles, Los Angeles, USA 3. Palliative Care, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA 4. Behavioral Health, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA  \nCorresponding author: Shelley J. Choi, [sjchoi@mednet.ucla.edu](sjchoi@mednet.ucla.edu)  \nAbstract  \nPalliative care (PC) is becoming increasingly integrated into the care of patients with advanced heart failure, although it is not yet widely incorporated into the heart transplant evaluation process. Patients undergoing evaluation for heart transplant carry a high burden of mental health morbidity, which can affect their ability to complete the evaluation and undergo successful transplantation. We describe the case of a 67-year-old male with ischemic cardiomyopathy on continuous inotropic support for decompensated heart failure, who initially declined to complete a transplant evaluation and expressed a desire for immediate hospital discharge. PC involvement clarified his prognosis without advanced heart failure therapies, and identified severe claustrophobia as the driver of his desire to end the transplant evaluation. With appropriate psychologic and psychiatric support, his claustrophobia became tolerable, and he underwent successful heart transplantation. With expertise in symptom management and effective communication, PC plays a crucial role as a bridge between medical and psychosocial teams, particularly when psychopathology is present. Appropriate PC involvement in the transplant evaluation process can identify and navigate barriers, and ensure goal-concordant, patient-centered care.  \nCategories: Palliative Care  \nKeywords: claustrophobia, goals of care, orthotopic heart transplantation, palliative care, transplant candidacy, transplant evaluation  \nIntroduction  \nPalliative care (PC) is an increasingly well-established treatment paradigm for end-stage organ failure [1] . Alleviating suffering through complex symptom management and advocating for goal-concordant care makes PC well-suited to address the high burden of symptoms, morbidity, and mortality associated with end-stage organ disease [2-5]. PC in advanced heart failure is an emerging field, with randomized trials and large observational studies demonstrating a link between PC and improvement in the quality of life and healthcare utilization for these patients, but not mortality benefit [2,6] . The American College of Cardiology/American Heart Association/Heart Failure Society of America (ACC/AHA/HFSA) 2022 Heart Failure Guidelines advocate for early and routine involvement of PC for those with advanced heart failure, including those undergoing evaluation for advanced therapies [7] . In clinical practice, PC is not commonly involved in the evaluation for solid organ transplant (SOT), but it is often integrated into patient care when attempts at advanced therapies have been unsuccessful and a patient is nearing the end of life [8] . Small observational studies of PC within heart transplantation have demonstrated feasibility and a trend toward improved quality of life [9] . Studies have focused predominantly on how PC alleviates the emo","cbCaiegyrOcibyYj","https://ap.wps.com/l/cbCaiegyrOcibyYj","pdf",596705,"English","# Abstract\n# Introduction\n# Case Presentation","[{\"question\":\"Why is palliative care important in advanced heart failure and transplant evaluation?\",\"answer\":\"Palliative care helps alleviate complex symptom burden and supports goal-concordant care. It may identify and manage barriers during transplant evaluation, especially when significant psychopathology is present.\"},{\"question\":\"What barrier prevented the patient from completing the transplant evaluation initially?\",\"answer\":\"Severe claustrophobia drove the patient’s desire to end the transplant evaluation and request immediate hospital discharge.\"},{\"question\":\"How did palliative care contribute to the patient’s successful outcome?\",\"answer\":\"PC clarified prognosis without advanced heart failure therapies and used effective communication plus psychological and psychiatric support to make the claustrophobia tolerable. The patient then completed the evaluation and underwent successful heart transplantation.\"}]","Early Palliative Care in Heart Transplant Evaluation | PDF",1790754638,15]