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Resilience in Heart Transplant Candidates

Y. T. Bui1, D. S. Yip2, B. W. Hardaway3, S. M. Dunlay4, S. Jowsey-Gregoire5, R. Benzo6, R. C. Daly7, M. A. Hathcock8, K. Thompson9, C. C. Kennedy10

1Mayo Clinic Alix School of Medicine, 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, 6Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 7Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, 8Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, 9Pulmonary Clinical Research Unit, Mayo Clinic, Rochester, MN, 10William J. von Liebig Center for Transplantation and Regenerative Medicine, Mayo Clinic, Rochester, MN

Meeting: 2020 American Transplant Congress

Abstract number: B-257

Keywords: Heart transplant patients, Psychosocial

Session Information

Session Name: Poster Session B: Heart and VADs: All Topics

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Resilience is the capacity to adapt to or recover from adverse experiences. Our objective was to measure resilience in waitlisted, adult heart transplant candidates using the validated Connor-Davidson Resilience Scale (RISC-10) and examine scores as a predictor of transplant-related outcomes.

*Methods: Candidates on the heart transplant waiting list at 1 of 3 US transplant centers were mailed prospective RISC-10 questionnaires between 9/16/2015 to 3/28/2019. After 3 recruitment attempts, non-responders were declared non-participators. Enrollees received annual surveys until transplant, death, or delisting. Post-transplant surveys were collected between 3-12 months following transplant. Additional demographic and transplant data were abstracted from the electronic health record. Statistical analyses included Chi-square or Kruskal-Wallis, Wilcoxon, and Age-adjusted Poisson regression models. P-values <0.05 were significant.

*Results: Participation was 48% (N=195). A majority were male (68%), white (85%), and married (72%). Baseline RISC-10 scores averaged 31.9±6, which is comparable to expected population norms (32.1±5.8). However, 34 participants (17%) had scores ≥ 1 SD below expected norms. Baseline RISC-10 scores did not differ by sex, race, marital status, education, hospitalization status, or functional measures (% predicted VO2 max, Karnofsky, or 6 minute walking distance). RISC-10 scores did not change while waitlisted (mean change of 0.5±5.3; p=0.38; N=76). During the study, 92 participants were transplanted, 7 were delisted due to deterioration, and 14 died while on the waitlist. Nine patients died post-transplant. Post-transplant RISC-10 scores increased by a mean of 0.9±5.7; p=0.22; N=67. Baseline RISC-10 scores were not associated with waitlist or post-transplant death, delisting, or rejection but were associated with length of stay (LOS) (adjusted relative risk 0.987; p=0.01).

*Conclusions: In heart transplant candidates, resilience was comparable to population norms. However, 1 in 5 patients had low resilience suggesting select patients may benefit from resilience training interventions. RISC-10 scores did not change during listing or after transplant. RISC-10 was not associated with death, delisting, or rejection but was associated with LOS.

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To cite this abstract in AMA style:

Bui YT, Yip DS, Hardaway BW, Dunlay SM, Jowsey-Gregoire S, Benzo R, Daly RC, Hathcock MA, Thompson K, Kennedy CC. Resilience in Heart Transplant Candidates [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/resilience-in-heart-transplant-candidates/. Accessed May 16, 2025.

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