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Hope KD, Bhat PN, Dreyer WJ, et al. Pediatric Palliative Care in the Heart Failure, Ventricular Assist Device and Transplant Populations: Supporting Patients, Families and Their Clinical Teams. Children (Basel). 2021;8(6)doi: 10.3390/children8060468.
Hope, K. D., Bhat, P. N., Dreyer, W. J., Elias, B. A., Jump, J. L., Santucci, G., Afonso, N. S., Ninemire, M. R., Achuff, B. J., Kritz, E. M., Gowda, S. H., & Puri, K. (2021). Pediatric Palliative Care in the Heart Failure, Ventricular Assist Device and Transplant Populations: Supporting Patients, Families and Their Clinical Teams. Children (Basel, Switzerland), 8(6), . https://doi.org/10.3390/children8060468
Hope, Kyle D, et al. "Pediatric Palliative Care in the Heart Failure, Ventricular Assist Device and Transplant Populations: Supporting Patients, Families and Their Clinical Teams." Children (Basel, Switzerland) vol. 8,6 (2021). doi: https://doi.org/10.3390/children8060468
Hope KD, Bhat PN, Dreyer WJ, Elias BA, Jump JL, Santucci G, Afonso NS, Ninemire MR, Achuff BJ, Kritz EM, Gowda SH, Puri K. Pediatric Palliative Care in the Heart Failure, Ventricular Assist Device and Transplant Populations: Supporting Patients, Families and Their Clinical Teams. Children (Basel). 2021 Jun 02;8(6). doi: 10.3390/children8060468. PMID: 34199474; PMCID: PMC8228348.
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Children (Basel). 2021 Jun 02;8(6). doi: 10.3390/children8060468.

Pediatric Palliative Care in the Heart Failure, Ventricular Assist Device and Transplant Populations: Supporting Patients, Families and Their Clinical Teams.

Children (Basel, Switzerland)

Kyle D Hope, Priya N Bhat, William J Dreyer, Barbara A Elias, Jaime L Jump, Gina Santucci, Natasha S Afonso, Margaret R Ninemire, Barbara-Jo Achuff, Erin M Kritz, Sharada H Gowda, Kriti Puri

Affiliations

  1. Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
  2. Section of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
  3. Michael E. DeBakey Department of Surgery and Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
  4. Section of Pediatric Palliative Care, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
  5. Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.

PMID: 34199474 PMCID: PMC8228348 DOI: 10.3390/children8060468

Abstract

Heart failure is a life-changing diagnosis for a child and their family. Pediatric patients with heart failure experience significant morbidity and frequent hospitalizations, and many require advanced therapies such as mechanical circulatory support and/or heart transplantation. Pediatric palliative care is an integral resource for the care of patients with heart failure along its continuum. This includes support during the grief of a new diagnosis in a child critically ill with decompensated heart failure, discussion of goals of care and the complexities of mechanical circulatory support, the pensive wait for heart transplantation, and symptom management and psychosocial support throughout the journey. In this article, we discuss the scope of pediatric palliative care in the realm of pediatric heart failure, ventricular assist device (VAD) support, and heart transplantation. We review the limited, albeit growing, literature in this field, with an added focus on difficult conversation and decision support surrounding re-transplantation, HF in young adults with congenital heart disease, the possibility of destination therapy VAD, and the grimmest decision of VAD de-activation.

Keywords: heart failure; heart transplant; palliative care; ventricular assist device

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