Paediatric heart/heart-lung transplantation: A systemic perspective on assessment and preparation

This paper is based upon our experience as a psychosocial team working on t he paediatric heart/heart-lung (H/HLT) programme for the last 10 years. Dur ing this time more than 350 children have been assessed, 240 have been put onto an active waiting list ann 160 have had transplants. The essence of th is payer is a detailed description of the multidisiplinary and comprehensiv e approach to children who are being considered for heart or heart-lung tra nsplantation, and their families. The hey issues of which we have become aw are are: creating a therapeutic alliance; listening to and involving the ch ildren; involving the wider network; understanding the family's illness nar rative and their individual belief systems, including issues of culture, et hnicity ann spirituality; acknowledging and addressing the power imbalance between the child/family and professional.