Intellectual and Developmental Disabilities in Transplant Patients

Organ transplantation is a complex multi-step process in which a person’s medical, surgical, psychological, and social standing and needs are evaluated in detail. Psychiatrists assume a unique role of gathering and integrating a patient’s medical, social, and psychiatric histories to assess the patient’s psychosocial readiness for organ transplant. In this chapter, we explore both the historical and current practices of assessing intellectual and developmental disabilities as a part of the pre-transplant psychiatric evaluation. We also discuss consideration of aspects of intellect, cognition, and behavior that could impact the ability to perform or receive post-transplant care. This chapter provides the necessary information for a psychiatrist to engage more effectively with individuals that have intellectual and developmental disabilities, avoid biased evaluation, assist in preparing such candidates for transplant, and advocate on behalf of this vulnerable population. We achieve these goals by discussing two clinical vignettes of Autism Spectrum Disorder and Danon Disease.