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Psychiatric Evaluations of Heart Transplant Candidates: Predicting Post-Transplant Hospitalizations, Rejection Episodes, and Survival

Received July 12, 2004; revised June 1, 2005; accepted June 23, 2005. From the Dept. of Psychology, Loma Linda University and the Dept. of Psychiatry and Behavioral Sciences, University of California, Los Angeles. Send correspondence and reprint requests to Jason E Owen, Ph.D., M.P.H., Dept. of Psychology, Loma Linda University, 11130 Anderson St., Loma Linda, CA 92350. e-mail: JOWEN{at}LLU.EDU

The authors assessed the validity of psychiatric evaluations for orthotopic heart transplant candidates with respect to predicting adverse post-transplant outcomes. A group of 108 transplant recipients were followed for an average of 970 days, and pre-transplant evaluations were retrospectively coded for psychiatric risk factors. Previous suicide attempts, poor adherence to medical recommendations, previous drug or alcohol rehabilitation, and depression significantly predicted attenuated survival times. Also, past suicide attempt was associated with a greater risk for post-transplant infection. Assessment and early treatment for these risk factors may reduce post-transplant morbidity and mortality.

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