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Psychiatric Disorders and Survival After Lung Transplantation

Received May 6, 1998; revised September 14, 1998; accepted September 23, 1998. From the University of Iowa and Veterans Administration Hospital, Iowa City, Iowa. Address correspondence and reprint requests to Dr. Woodman, University of Iowa and Veterans Administration Hospital, 200 Hawkins Dr., Iowa City, IA 52242; e-mail: woodman.catherine_L{at}iowa-city.va.gov

The 30 patients who underwent lung transplantation between 1990 and 1996 were included in this study, and data were analyzed to find predictors of 1-year survival posttransplantation. All patients were followed throughout the posttransplantation period. Fifteen patients had a pretransplantation diagnosis of an anxiety and/or depressive disorders. Of the 30 patients transplanted, 19 survived 12 months or more, and 11 died less than 12 months posttransplantation. The >12-month survival group had a mean age of 45.2 years at transplantation, compared with a mean age of 43.0 years in the <12-month group (NS). The mean Psychosocial Assessment of Candidates for Transplant score and premorbid history of smoking did not differ between the groups. The >12-month survival group had more psychiatric illness pretransplantation than the <12-month survival group (56% vs. 27%, P<0.05). The recipients with a psychiatric history (N=15) were more likely to survive 1 year posttransplantation than the recipients without a psychiatric history (80% vs. 47%, P<0.05) and were not significantly different from the recipients without a psychiatric history in terms of episodes of rejection, bronchiolitis obliterans, or noncompliance with treatment. Depression and anxiety are treatable disorders that occur frequently in patients with end-stage lung disease, and a premorbid history of either did not predict a worse outcome posttransplantation in this study of lung transplantation recipients.

Key Words: Transplants • Syndromes Secondary to General Medical Disorders • Predictors of Outcome

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