Heart or heart–lung transplantation: Psychosocial outcome

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Abstract
The psychosocial outcome of 23 heart and 21 heart–lung transplant recipients, aged 5–17 yrs, was determined and compared with the psychosocial outcome of a group of 46 children and adolescents who underwent conventional cardiac surgery. Preoperatively, and 12 months post‐operatively, the patients’ physical health status, mental state (ICD‐9) and level of psychosocial functioning (GAF scale, DSM‐IIIR) were assessed. There was an improvement in physical health in all groups. Preoperatively, psychiatric disorder, including anxiety and phobic states, depression and adjustment reaction, was noted in 6/23 (26%) children assessed for heart transplantation, 6/21(28.5%) children assessed for heart–lung transplantation, and 12/46 (26%) children undergoing conventional cardiac surgery. The prevalence of psychiatric disorder remained in the transplant group but decreased in the non‐transplant comparison group (6.5%). Improvement in overall levels of psychosocial functioning were found in all groups, but over 40% of all the participants were still functioning below normal levels. In summary, children with end‐stage cardio‐respiratory disease benefit physically and psychologically from heart or heart–lung transplantation treatment but there is a need for systematic psychosocial support both before and after transplantation.

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