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Open Access Highly Accessed Case report

End-of-life care in a COPD patient awaiting lung transplantation: a case report

Daisy JA Janssen123*, Martijn A Spruit1, Joan D Does1, Jos MGA Schols4 and Emiel FM Wouters15

Author Affiliations

1 Program Development Centre, Ciro, centre of expertise for chronic organ failure, Horn, the Netherlands

2 CAPHRI, Maastricht University, Maastricht, the Netherlands

3 Proteion Thuis, Horn, the Netherlands

4 Department of General Practice, Nursing home medicine, Faculty of Health Medicine and Life sciences/CAPHRI, Maastricht University, Maastricht, the Netherlands

5 Department of Respiratory Medicine, Maastricht University Medical Centre + (MUMC+), Maastricht, the Netherlands

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BMC Palliative Care 2010, 9:6  doi:10.1186/1472-684X-9-6

Published: 28 April 2010

Abstract

COPD is nowadays the main indication for lung transplantation. In appropriately selected patients with end stage COPD, lung transplantation may improve quality of life and prognosis of survival. However, patients with end stage COPD may die while waiting for lung transplantation. Palliative care is important to address the needs of patients with end stage COPD. This case report shows that in a patient with end stage COPD listed for lung transplantation offering palliative care and curative-restorative care concurrently may be problematic. If the requirements to remain a transplantation candidate need to be met, the possibilities for palliative care may be limited. Discussing the possibilities of palliative care and the patient's treatment preferences is necessary to prevent that end-of-life care needs of COPD patients dying while listed for lung transplantation are not optimally addressed. The patient's end-of-life care preferences may ask for a clear distinction between the period in which palliative and curative-restorative care are offered concurrently and the end-of-life care period. This may be necessary to allow a patient to spend the last stage of life according to his or her wishes, even when this implicates that lung transplantation is not possible anymore and the patient will die because of end stage COPD.