Psychosocial factors and quality-of-life after heart transplantation and mechanical circulatory support

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Abstract
Purpose of review Psychosocial outcomes and quality-of-life (QOL) are important indicators of the success of heart transplantation and mechanical circulatory support (MCS). They warrant further research attention given the increasing frequency of these interventions and the diverse uses of MCS as destination therapy and bridge to transplant. Recent findings The literature has continued to identify correlates and predictors of psychosocial outcomes in five domains: physical functioning, psychological, behavioral, social functioning and global QOL. These issues in MCS patients, in particular, are receiving increased attention. Recent work also highlights the potential for psychosocial outcomes to predict transplant-related and MCS-related clinical outcomes, and also emphasizes issues involved in heart transplantation for older adults, heart transplantation for intellectually disabled individuals, and managing end-of-life planning in patients with MCS. Summary This field continues to be dominated by descriptive studies. Although recent work has provided a more complete picture of correlates of psychosocial outcomes, there is a need for intervention research to examine strategies to optimize these outcomes in both heart transplant and MCS populations. Clinicians should continue to monitor and address psychosocial issues with their patients in order to achieve posttransplant and postimplantation success that prolongs both quantity and QOL.

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