Affect in Patients Awaiting Heart Transplant
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, 2Department of Transplantation, Mayo Clinic, Jacksonville, FL, 3Division of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ, 4Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, 5Department of Psychiatry, Mayo Clinic, Rochester, MN, 6Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, 7Department of Health Services Research -Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, 8Pulm onary Clinical Research Unit, Mayo Clinic, Rochester, MN, 9William J. von Liebig Center for Transplantation and Regenerative Medicine, Mayo Clinic, Rochester, MN
Meeting: 2020 American Transplant Congress
Abstract number: B-235
Keywords: Heart, Heart/lung transplantation, Psychosocial
Session Information
Session Name: Poster Session B: Psychosocial and Treatment Adherence
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Affect refers to an individual’s emotional response .It may be categorized as positive or negative. Affect in heart transplant candidates is under-explored. We aimed to describe the affect of heart transplant candidates, affects’ change over time, and possible relationships to post- transplant outcomes
*Methods: This was a multi-center prospective survey of adult heart transplant candidates on the waiting list. We used the Positive and Negative Affect Schedule (PANAS) to measure positive and negative affect scores annually and post-transplant. Secondary outcomes included baseline positive and negative affect scores as possible predictors of transplant-related outcomes. A positive affect (PA) to negative affect ( NA) ratio (PR) of ≥2.9 is considered optimal and we also explored PR≥2.9 as a possible predictor. P-values ≤ 0.05 were significant.
*Results: Patients were majority male (69%) and white (85%). Median age was 57 (N=194). More than a quarter of subjects reported via PANAS they were moderately to extremely: distressed (28%), scared (30.8%), irritable (30%), nervous (36.9%), and/or afraid (25.3%). Baseline median PA and NA scores (37 and 17, respectively) were comparable to expected population norms. Neither PA nor NA changed while listed (1.4±6.8; p=0.69 and 0.4±5.6; p=0.89, respectively). Mean PR was low at baseline (2.3), with 26.8% ≤2.9 and did not change significantly while waiting (0.1±0.96; p=0.74). During the study, 92 patients were transplanted (with 9 deaths), 14 patients died while listed and 63 were still waiting. Neither PA nor NA scores were associated with death/delisting. The PR decreased following transplant by a mean of 0.3 ±1.2; p=0.03. Baseline PA and PR were not associated with length of stay (LOS), readmissions, or rejection. NA, however, was associated with LOS (adjusted relative risk 1.02; p<0.01) but not rejection or readmission.
*Conclusions: More than a quarter of patients were below optimal PR threshold at baseline. Heart transplant alone does not improve affect, in fact, PR significantly worsens post-transplant. In addition,NA is associated with post-transplant LOS. Future studies should investigate potential interventions to improve negative affect and PR in heart transplant patients.
To cite this abstract in AMA style:
Ahmed A, Yip DS, Hardaway BW, Boilson BA, Schneekloth TD, Benzo R, Daly R, Hathcock MA, Johnson BK, Thompson K, Kennedy CC. Affect in Patients Awaiting Heart Transplant [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/affect-in-patients-awaiting-heart-transplant/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress