C47-26 Impact of Routine Early Palliative Care Consultation on 1-year Mortality After Heart Transplant

Abstract Introduction Palliative care assessment is recommended for patients undergoing evaluation for thoracic transplantation. Despite this recommendation and increasing evidence of its benefits, concern remains about potential negative impacts of early palliative care on transplant outcomes, including short-term mortality. Here we present a 10-year retrospective study on the impact of early palliative care on 1-year mortality in heart transplant. Methods Baseline characteristics were compared between patients pre- and post-palliative care consult implementation; 2012-2017 and 2017-2022, respectively. One-year mortality was assessed using a Cox proportional hazards model, controlling for relevant confounders including age, body mass index (BMI), diabetes, functional status, medical condition at transplant, acute rejection, and length of stay. Results The pre- (N = 100) and post-intervention group (N = 121) demonstrated comparable baseline characteristics except for severity of illness: the post-palliative intervention group was sicker with lower functional status, higher severity of illness at time of transplant, longer length of stay, and higher rates of early rejection (p 0.001). Despite the increased complexity of the post-palliative intervention group, there was no difference in 1-year mortality when compared to the pre-intervention group (HR 1.28, 95% CI 0.28-5.95, p = 0.75). Conclusion Early palliative care consultation in heart transplant patients was not associated with increased 1-year mortality despite a sicker patient population, suggesting that existing concerns about negative impacts of these collaborations on mortality are not supported by the data. This association and the impact of early palliative care on patient decision making and quality of life in heart transplant needs to be further explored. This abstract is funded by: N/A