Health-Related Quality of Life Impairments and Benefits 15-19 Years after Lung or Heart Transplant

Purpose Growing numbers of patients are entering the very late term period (15+ yrs) of survivorship after cardiothoracic transplant (CTx). Their health-related quality of life (HRQOL) is unknown. We examined (a) degree of late-term HRQOL impairment in multiple domains, (b) HRQOL benefit in areas of personal growth and life satisfaction, and (c) demographic, psychosocial, and clinical correlates of HRQOL. Methods Among 178 lung and 126 heart recipients from a single-site prospective study during the first 2 yrs post-CTx, we recontacted survivors 15-19 yrs post-CTx. We used validated scales to assess HRQOL impairments (SF-36) and benefits (personal growth from transplant experience [Post-Traumatic Growth Inventory]; having new life goals [Life Engagement Scale]; global life satisfaction rating). We examined HRQOL outcomes’ associations with other patient characteristics using multivariable regression. Results Of 82 survivors, 64 (84%) were assessed (n=29 lung, 35 heart recipients; M±SD=16±1 y post-CTx, range 15-19; 61% male; age 66±11). They were impaired in physical functional HRQOL domains, relative to norms (Fig 1). Mean mental health and social functioning were similar to or better than norms. Personal growth, and life engagement and satisfaction averaged higher than the scales’ midpoints (p Conclusion Despite physical functional HRQOL impairments in the late years after CTx, mental and social HRQOL is strikingly high and other HRQOL benefits are prominent. Because patients with more dyspnea and poorer psychosocial resources appear at risk for more HRQOL impairment and less HRQOL benefit, interventions targeting such individuals may help to maximize their HRQOL.