Factors influencing the survival of recipients after heart transplantation: a five-year retrospective study

• Authors: Irena Milaniak , Karol Wierzbicki , Piotr Przybyłowski

Title variants

PL

Czynniki wpływające na przeżycie biorców po transplantacji serca: 5-letnie badanie retrospekcyjne

Abstracts

PL

Wprowadzenie: Przeszczepienie serca pozostaje standardem postępowania w leczeniu schyłkowej niewydolności serca. Ocena wyników przeszczepu serca, w tym śmiertelności i jej czynników prognostycznych, jest bardzo ważna dla ośrodków transplantacyjnych. Celem pracy jest zbadanie możliwego wpływu jakości życia, objawów depresyjnych, optymizmu, poczucia własnej skuteczności oraz danych medycznych na przeżycie wśród biorców serca w 5-letnim okresie obserwacji. Materiał i metody: Badaniem objęto 131 biorców przeszczepu serca. Funkcjonowanie psychologiczne i jakość życia oceniano za pomocą samoopisowych skal (Inwentarz Depresji Becka, Test Orientacji Życiowej, Skala Uogólnionej Własnej Skuteczności oraz Jakość Życia Światowej Organizacji Zdrowia). Dane kliniczne uzyskano z elektronicznego rekordu pacjenta. Wyniki: W okresie obserwacji o medianie 5 lat zmarło 24% pacjentów. Wystąpienie choroby naczyniowej graftu dwukrotnie zwiększało ryzyko zgonu w badanej populacji (HR = 2,17 [1,066, 14,446], p = 0,032). U pacjentów z rozpoznaną niewydolnością serca w skali NYHA II–IV ryzyko zgonu pacjentów było dwukrotnie wyższe (HR = 2,18 [1,043, 4,578], p = 0,037) w porównaniu z oceną NYHA I. Wnioski: Ani jakość życia, ani czynniki psychologiczne nie były związane z 5-letnim przeżyciem. Jedynie waskulopatia tętnic wieńcowych i wyższa skala NYHA po przeszczepieniu serca były niezależnymi predyktorami 5-letniej śmiertelności wśród biorców serca.

EN

Introduction: Cardiac transplantation remains the standard procedure for patients with end-stage heart failure. Assessing the outcomes of heart transplantation, including mortality and its predictors, is highly important for transplant centers. The aim of this study is to explore the possible influence of the quality of life, depressive symptoms, optimism, self-efficacy, and medical data on survival among heart transplant recipients over a five-year observational period. Material and methods: 131 heart transplant recipients were included in this study. Psychological functioning and quality of life were assessed using self-reported measures (Beck Depression Inventory, Life Orientation Test, General Self Efficacy Scale, and World Health Organization Quality of Life). Clinical data were obtained from an electronic health record. Results: During a median follow-up of five years, 24% of patients died. The occurrence of vascular graft disease increased the risk of death twofold in the population studied (HR = 2.17 [1.066, 14.446], p = 0.032). In the patients diagnosed with heart failure on the NYHA scale, the risk of death for patients with a NYHA rating of II–IV was twice as high (HR = 2.18 [1.043, 4.578], p = 0.037) compared with a NYHA rating of I. Conclusions: Neither the quality of life nor psychological factors were associated with five-year survival. Only coronary artery vasculopathy and having a higher NYHA scale rating following heart transplantation were independently predictive of five-year mortality among heart transplant recipients.

Keywords

EN

quality of life; survival; heart transplantation

PL

przeszczep serca; jakość życia; przeżycie

• Publisher: Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
• Journal: Państwo i Społeczeństwo
• Year: 2022
• Issue: 1
• Pages: 55-70

Dates

published

2022

Contributors

author

Irena Milaniak

• Andrzej Frycz Modrzewski Kakow University, Faculty of Medicine and Health Sciences, Department of Nursing, Krakow, Poland

author

Karol Wierzbicki

• Jagiellonian University Medical College, Krakow, Poland

author

Piotr Przybyłowski

• Silesian Center for Heart Diseases in Zabrze, Poland

References

• Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Kardiol Pol. 2016; 74(10): 1037–1147. doi: 10.5603/KP.2016.0141.
• Jessup M, Drazner MH, Book W, Cleveland JC Jr, Dauber I, Farkas S, Ginwalla M, Katz JN, Kirkwood P, Kittleson MM, Marine JE, Mather P, Morris AA, Polk DM, Sakr A, Schlendorf KH, Vorovich EE. 2017 ACC/AHA/HFSA/ISHLT/ACP Advanced Training Statement on Advanced Heart Failure and Transplant Cardiology (Revision of the ACCF/AHA/ACP/HFSA/ISHLT 2010 Clinical Competence Statement on Management of Patients With Advanced Heart Failure and Cardiac Transplant): A Report of the ACC Competency Management Committee. J Am Coll Cardiol. 2017; 69(24): 2977–3001. doi: 10.1016/j.jacc.2017.03.001.
• Khush KK, Cherikh WS, Chambers DC, Goldfarb S, Hayes D Jr, Kucheryavaya AY, Levvey BJ, Meiser B, Rossano JW, Stehlik J; International Society for Heart and Lung Transplantation. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-fifth Adult Heart Transplantation Report-2018; Focus Theme: Multiorgan Transplantation. J Heart Lung Transplant. 2018; 37(10): 1155–1168. doi: 10.1016/j.healun.2018.07.022.
• Czerwiński J, Antoszkiewicz K, Borczon S, Danek T, Hermanowicz M, Lęczycka A, Pszenny A, Przygoda J. Rejestr przeszczepień narządów. Poltransplant Biuletyn Informacyjny. 2018; 1(26): 48–51.
• Politi P, Piccinelli M, Fusar-Poli P, Klersy C, Campana C, Goggi C, Viganò M, Barale F. Ten years of “extended” life: quality of life among heart transplantation survivors. Transplantation. 2004; 78(2): 257–263. doi: 10.1097/01. TP.0000133537.87951.F2. Erratum in: Transplantation. 2012 15; 94(3): e22. Poli, Paolo Fusar [corrected to Fusar-Poli, Paolo].
• Triffaux JM, Wauthy J, Bertrand J, Limet R, Albert A, Ansseau M. Psychological evolution and assessment in patients undergoing orthotopic heart transplantation. Eur Psychiatry. 2001; 16(3): 180–185. doi: 10.1016/s0924-9338(01)00561-2.
• Okwuosa I, Pumphrey D, Puthumana J, Brown RM, Cotts W. Impact of identification and treatment of depression in heart transplant patients. Cardiovasc Psychiatry Neurol. 2014; 2014: 747293. doi: 10.1155/2014/747293.
• McCartney SL, Patel C, Del Rio JM. Long-term outcomes and management of the heart transplant recipient. Best Prac Res Clin Anaesthesiol. 2017; 31(2): 237–248. doi: 10.1016/j.bpa.2017.06.003.
• Dew MA, Rosenberger EM, Myaskovsky L, DiMartini AF, DeVito Dabbs AJ, Posluszny DM, Steel J, Switzer GE, Shellmer DA, Greenhouse JB. Depression and Anxiety as Risk Factors for Morbidity and Mortality After Organ Transplantation: A Systematic Review and Meta-Analysis. Transplantation. 2015; 100(5): 988–1003. doi: 10.1097/TP.0000000000000901.
• Dhar AK, Barton DA. Depression and the Link with Cardiovascular Disease. Front Psychiatry. 2016; 7: 33. doi: 10.3389/fpsyt.2016.00033.
• Havik OE, Sivertsen B, Relbo A, Hellesvik M, Grov I, Geiran O, Andreassen AK, Simonsen S, Gullestad L. Depressive Symptoms and All-Cause Mortality AfterHeart Transplantation. Transplantation. 2007; 84(1): 97–103. doi: 10.1097/01.tp.0000268816.90672.a0.
• Brandwin M, Trask PC, Schwartz SM, Clifford M. Personality predictors of mortality in cardiac transplant candidates and recipients. J Psychosom Res. 2000; 49(2): 141–147.
• Coglianese EE, Samsi M, Liebo MJ, Heroux AL. The Value of Psychosocial Factors in Patient Selection and Outcomes after Heart Transplantation. Curr Heart Fail Rep. 2015; 12(1): 42–47. doi: 10.1007/s11897-014-0233-5.
• Farmer SA, Grady KL, Wang E, McGee EC Jr, Cotts WG, McCarthy PM. Demographic, psychosocial, and behavioral factors associated with survival after heart transplantation. Ann Thorac Surg. 2013; 95(3): 876–883. doi: 10.1016/j. athoracsur.2012.11.041.
• Hoodin F, Uberti JP, Lynch TJ, Steele P, Ratanatharathorn V. Do negative or positive emotions differentially impact mortality after adult stem cell transplant. Bone Marrow Transplant. 2006; 38(4): 255–264. doi: 10.1038/sj.bmt.1705419.
• Reynolds WM, Gould JW. A psychometric investigation of the standard and short form Beck Depression Inventory. J Consult ClinPsychol. 1981; 49(2): 306–307. doi: 10.1037//0022-006X.49.2.306.
• Groth-Marnat G. The handbook of psychological assessment. 2nd ed., John Wiley & Sons, New York 1990.
• Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the Life Orientation Test. J Pers Soc Psychol. 1994; 67(6): 1063–1078. doi: 10.1037//0022-3514.67.6.1063.
• Juczynski Z. Narzędzia Pomiaru w Promocji i Psychologii Zdrowia. Wyd. 2. Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego, Warszawa 2012.
• Schwarzer R, Jerusalem M. Generalized Self-Efficacy scale [In:] Weinman J, Wright S, Johnston M (eds.) Measures in health psychology: A user’s portfolio. Causal and control beliefs. NFER-NELSON, Windsor, UK 1995: 35–37.
• Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med. 1998; 28(3): 551–558. doi: 10.1017/s0033291798006667.
• Hajouli S, Ludhwani D. Heart Failure And Ejection Fraction. National Library of Medicine; https://www.ncbi.nlm.nih.gov/books/NBK553115 [accessed:22.04.2022].
• Mehra MR, Crespo-Leiro MG, Dipchand A, Ensminger SM, Hiemann NE, Kobashigawa JA, Madsen J, Parameshwar J, Starling RC, Uber PA. International Society for Heart and Lung Transplantation working formulation of a standardized nomenclature for cardiac allograft vasculopathy-2010. J Heart Lung Transplant. 2010; 29(7): 717–727. doi: 10.1016/j.healun.2010.05.017.
• Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA, Kurella Tamura M, Feldman HI. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014; 63(5): 713–735. doi: 10.1053/j.ajkd.2014.01.416.
• Goldraich LA, Stehlik J, Kucheryavaya AY, Edwards LB, Ross HJ. Retransplant and Medical Therapy for Cardiac Allograft Vasculopathy: International Society for Heart and Lung Transplantation Registry Analysis. Am J Transplant. 2016; 16(1): 301–309. doi: 10.1111/ajt.13418.
• Van Keer JM, Van Aelst LNL, Rega F, Droogne W, Voros G, Meyns B, Vanhaecke J, Emonds MP, Janssens S, Naesens M, Van Cleemput J. Long-term outcome of cardiac allograft vasculopathy: importance of the International Society for Heart and Lung Transplantation angiographic grading scale. J Heart Lung Transplant. 2019; 38(11): 1189–1196. doi: 10.1016/j.healun.2019.08.005.
• Sponga S, Travaglini C, Pisa F, Piani D, Guzzi G, Nalli C, Spagna E, Tursi V, Livi U. Does psychosocial compliance have an impact on long-term outcome after heart transplantation?. Eur J Cardiothoracic Surg. 2016; 49(1): 64–72. doi:10.1093/ejcts/ezv120.
• Previato M, Osto E, Kerkhof PLM, Parry G, Tona F. Heart Transplantation Survival and Sex-Related Differences. Adv Exp Med Biol. 2018; 1065: 379–388. doi:10.1007/978-3-319-77932-4_24.
• Smith PJ, Blumenthal JA, Trulock EP, Freedland KE, Carney RM, Davis RD, Hoffman BM, Palmer SM. Psychosocial Predictors of Mortality Following Lung Transplantation. Am J Transplantat. 2016; 16(1): 271–277. doi. 10.1111/ajt.13447.

Identifiers

DOI

10.48269/2451-0858-pis-2022-1-004

Biblioteka Nauki

2129674