Quality of Life in Patients 20–31 Years After Heart Transplantation

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2024-07-25 DOI:10.1111/ctr.15400

Wolfgang Albert, Anita Hudalla, Luisa Hensky, Aslı Akın, Christoph Knosalla, Fabian Richter

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Abstract

Background

Survival rates after heart transplantation (HTx) have significantly improved over the last decades. There is a growing need to understand the long-term psychological and somatic outcomes, which constitute quality of life (QoL), for these long-term survivors.

Methods

The QoL of patients (N = 75) living 20–31 years (M = 24.9 years, SD = 2.3 years) after orthotopic HTx was evaluated. In a first step, a detailed overview of the patients’ somatic condition was assessed. Secondly, patients were compared to 58 control subjects in terms of self-reported QoL (SF-36) and psychological domains (GBB-24; HADS). Finally, a cluster analysis was conducted to identify patterns within the patient-reported outcome measures (PROMs) and to relate them to somatic, psychosocial, and demographic variables.

Results

95.7% of the HTx-patients were in NYHA functional class I or II, and only 15.2% had a reduced LVEF. Compared to controls, long-term HTx patients had significantly lower scores on the physical component summary (PCS) of QoL and on the GBB-24 but not in the mental component summary (MCS) of QoL, or anxiety and depression (HADS). Clustering revealed two distinct groups of patients characterized by high versus low functioning and different levels of social support.

Conclusions

Long-term survivors have a good functional, cardiac, and mental status, but report a lower physical QoL and higher levels of subjective complaints. The importance of social support for HTx recipients is once again highlighted.

Abstract Image

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心脏移植术后 20-31 年患者的生活质量。

背景：过去几十年来，心脏移植（HTx）后的存活率有了显著提高。人们越来越需要了解这些长期幸存者的长期心理和躯体结果，即生活质量（QoL）：方法：对接受正位热塑疗法后存活 20-31 年（男 = 24.9 岁，女 = 2.3 岁）的患者（N = 75）的生活质量进行了评估。首先，对患者的躯体状况进行了详细评估。其次，在自我报告的 QoL（SF-36）和心理领域（GBB-24；HADS）方面，将患者与 58 名对照组受试者进行比较。最后，进行了聚类分析，以确定患者报告结果指标（PROMs）的模式，并将其与躯体、社会心理和人口统计学变量联系起来：95.7%的高血压患者处于NYHA功能分级I级或II级，只有15.2%的患者LVEF降低。与对照组相比，长期接受高通量血浆治疗的患者在质量生活的身体部分总结（PCS）和GBB-24上的得分明显较低，但在质量生活的精神部分总结（MCS）或焦虑和抑郁（HADS）上的得分却不高。聚类显示出两组不同的患者，他们的功能有高有低，社会支持程度也各不相同：结论：长期幸存者的功能、心脏和精神状况良好，但身体质量生活水平较低，主观抱怨较多。结论：长期幸存者的功能、心脏和精神状况良好，但身体QL较低，主观抱怨较多，这再次凸显了社会支持对高温热疗受者的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.