A consensus-based framework for the psychosocial evaluation of pediatric candidates for cardiothoracic transplant and ventricular assist devices

The psychosocial evaluation plays an essential role in the multidisciplinary assessment of pediatric patients for thoracic organ transplantation or ventricular assist device (VAD) placement. However, there is considerable practice variation with regard to the content and process of the evaluation, with no known recent published guidelines. Furthermore, the pediatric evaluation necessarily differs from the adult evaluation in a number of substantive ways, including caregiver roles and decision-making. A writing committee of 25 multidisciplinary experts in pediatric cardiothoracic transplantation/VAD was established, who conducted a comprehensive literature review which resulted in the development of this consensus-based framework. This framework, which is a collaborative effort of the International Society for Heart and Lung Transplantation (ISHLT), the International Pediatric Transplant Association (IPTA), the Pediatric Heart Transplant Society (PHTS), the Advancing Cardiac Therapies Improving Outcomes Network (ACTION), and Transplant Families, represents the first known framework specific to both the content and process of the psychosocial evaluation for pediatric cardiothoracic transplantation/VAD. Attention was paid to relevant ethical, cultural and health equity considerations inherent in the pediatric evaluation process. Rather than provide a proscriptive evaluation process, the goal was to create a flexible framework to encourage consistency across centers, while also acknowledging the complexities inherent in evaluating children and their families for cardiothoracic transplant and VAD.

Published by The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2025. The guideline itself is at the source linked here.

doi.org/10.1016/j.healun.2024.11.028