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<h3>Background</h3> There is consensus from the literature that Palliative Care should be involved with heart and lung transplant patients. Patients undergoing transplant assessment have end-stage organ failure and often have severe symptoms which limit function and reduce quality of life. Of the patients who undergo transplant assessment, some will not be listed, some will die awaiting an organ, and some will die of post-operative complications. In August 2022, the Supportive and Palliative Care Team (SPCT) at Royal Papworth Hospital were integrated into the transplant assessment timetable for all patients. <h3>Methods</h3> A retrospective review of notes was performed for all patients who underwent heart or lung transplant assessment at Royal Papworth Hospital (RPH), between 8th August 2022 and 3rd September 2024. 291 electronic patient records were reviewed, and data was extracted using a bespoke proforma. Data was analysed with descriptive statistics. <h3>Results</h3> Of the 291 patients seen, 159 had assessment for heart transplantation and 132 were assessed for lung transplantation. The age range was 17-65, and no patient declined SPCT review. 101 patients (35%) were signposted or referred to other services or resources. 55 patients (19%) were followed up or seen again by SPCT. The most common reason for ongoing or further SPCT input was emotional support (30 patients). At the time of data collection, 80 patients had received a transplant. 48 patients had died (9 post-transplant and 39 who had not received a transplant). <h3>Conclusion</h3> Palliative Care involvement in heart and lung transplant assessments is acceptable to patients and staff. It allows the opportunity to dispel myths and fears about what Palliative Care is and start to build rapport with patients and their support networks. It improves patient access to other services and resources, and allows early identification of symptom control needs, as well as psychological, social and emotional needs.