Engagement of Social Support Systems in Patients Being Considered for and Following Advanced Heart and Lung Surgical Therapies: An ISHLT Expert Consensus Statement.

Social support systems, particularly caregivers, play a critical role in the evaluation, treatment, and recovery of patients undergoing heart or lung transplantation or left ventricular assist device (LVAD) implantation. However, definitions, assessment practices, and expectations for social support vary considerably across programs, and evidence guiding optimal caregiver engagement remains limited. This International Society for Heart and Lung Transplantation expert consensus statement summarizes current evidence and provides recommendations for assessing, engaging, and supporting social support systems across adult and pediatric populations. A multidisciplinary international writing committee reviewed the literature and developed recommendations through a structured consensus process. Social support encompasses medical management, logistical, emotional, informational, psychological, and companionship assistance, with caregiver needs and responsibilities evolving across the treatment trajectory. Existing assessment approaches and interventions are heterogeneous, with limited longitudinal evidence. Consensus recommendations emphasize early caregiver identification and engagement, structured and tailored education and skills training, longitudinal assessment of caregiver needs and burden, integration of caregivers into clinical workflows, access to psychosocial and palliative care resources, and peer support. A strengths-based, individualized approach that recognizes social and structural barriers is recommended to promote equitable access and optimize patient and caregiver outcomes.