Original ArticlesEarly post-transplant medical compliance and mental health predict physical morbidity and mortality one to three years after heart transplantation☆
Section snippets
Respondents
A total of 166 adult (aged 18+) heart transplant patients from the Cardiothoracic Transplantation Program, University of Pittsburgh Medical Center, were enrolled in a longitudinal evaluation of health status during the first year following heart transplantation.6, 29 All adults surviving beyond the initial post-transplant recovery period (defined as the first 6 weeks following surgery) were eligible for the study (N = 174) and were initially contacted at that time; the refusal rate for the
Morbidity and mortality during followup period
During the period from 1 to 3 years post-transplant, 20.7% of the recipients experienced at least 1 episode of acute graft rejection (n = 28 of the 135 recipients with available biopsy data). Among these 28 persons, 19 (68%) had also had acute graft rejection episodes graded 3A or higher during the first year post-transplant, averaging 1.95 episodes each (SD = 0.85), with an average grade of 3A. Of the remaining 107 persons with no documented episodes during the period 1 to 3 years
Discussion
Although noncompliance with the post-transplant medical regimen and serious psychiatric distress post-transplant have been anecdotally noted to bode for a poorer post-transplant physical health course, the empirical documentation of such effects has been rare to nonexistent. There are no large-scale cohort studies of the role of these factors in mortality post-transplant. In the only quantitative analysis to date of their role vis-à-vis morbidity, Paris et al.2 examined the correlation of such
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This research was funded by grants MH45020 and MH30915 from the National Institute of Mental Health, and HL54326 from the National Heart, Lung and Blood Institute, Rockville, MD.