Shared Decision-Making in Solid Organ Transplantation: A Review
Abstract
:1. Introduction
2. Definitions: Informed Consent and Shared Decision-Making
3. Shared Decision-Making in the Solid Organ Transplant Journey
3.1. Pre-Transplant Stages
3.1.1. End-Stage Organ Disease Onset and Transplant Referral
3.1.2. Pre-Transplant Work-Up and Time on the Waiting List
3.2. Time of the Organ Offer
3.3. Post-Transplant Stages
3.3.1. Perioperative Period
3.3.2. Post Transplant and Long-Term Follow-Up
4. Barriers to Shared Decision-Making in Solid Organ Transplantation
4.1. Patient-Related Barriers
4.2. Healthcare Professional-Related Barriers
4.3. Systemic Barriers
5. Enabling Shared Decision-Making in Transplant Clinical Practice
5.1. Educational Resources for Patients
5.2. Prognostic Tools and Clinical Decision Aids
5.3. Clinician Training and Collaborative Care Models
5.4. Policy Development and Clinical Practice Guidelines
5.5. Use of Technology in SDM
5.6. Person-Centered Communication and Inclusion
6. Discussion
7. Future Directions
Funding
Conflicts of Interest
References
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Patient-Related Barriers | HCP-Related Barriers | System-Related Barriers |
---|---|---|
Limited health literacy | Attitudes towards recipient eligibility and access | Complex and fragmented healthcare systems |
Low socioeconomic status | Paternalistic attitudes | Poor coordination among specialists and care teams |
Inadequate empowerment from HCPs | Insufficient information sharing | Institutional policies and resource constraints |
Cognitive impairment | Lack of training on prognosis discussions | Cultural and organizational norms undervaluing patient input |
Lack of family and social support | Lack of communication training | Inconsistent reporting of person-centered outcomes in trials |
Cultural and language differences | Unawareness of available options among patients | Limited consultation time and lack of decision aids |
Emotional and psychological distress | Misconceptions | Lack of guidelines, protocols, and workflows for SDM implementation |
Comorbidities | ||
Misinformation about transplant processes | ||
Inadequate access to educational materials and decision aids | ||
Health system navigation challenges | ||
Socioeconomic and logistical barriers |
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Grossi, A.A. Shared Decision-Making in Solid Organ Transplantation: A Review. Transplantology 2025, 6, 1. https://doi.org/10.3390/transplantology6010001
Grossi AA. Shared Decision-Making in Solid Organ Transplantation: A Review. Transplantology. 2025; 6(1):1. https://doi.org/10.3390/transplantology6010001
Chicago/Turabian StyleGrossi, Alessandra Agnese. 2025. "Shared Decision-Making in Solid Organ Transplantation: A Review" Transplantology 6, no. 1: 1. https://doi.org/10.3390/transplantology6010001
APA StyleGrossi, A. A. (2025). Shared Decision-Making in Solid Organ Transplantation: A Review. Transplantology, 6(1), 1. https://doi.org/10.3390/transplantology6010001