Comparison of social support and psychosocial stress after heart and liver transplantation.

We studied social support, psychological symptoms, and subjective appraisal of quality of life among 233 patients at 1 to 3 years after heart (HTX) or orthotopic liver transplantation (OLT): 78 HTX in 62.8% men and 155 OLT in 51% men. Patients after OLT versus HTX were more often single or divorced (14.4% and 12.3% vs 3.9% and 7.7%), had better school education (68.4% vs 37.8%), and were more often employed (25.5% vs 11.8%). Among the HTX patients, 40.3% had more than 3 inpatient treatments due to complications after transplantation vs only 9.3% of OLT patients. HTX patients had more rejection reactions (55.4% vs 21%). Asked for their appraisal of quality of life, HTX and OLT patients gave comparably good "school grades" (2.6 vs 2.7), describing similar scores of social support in the F-SozU (4.4 vs 4.2). OLT patients, women in particular, reported a significantly higher grade of global psychological stress than HTX patients (67.4 vs 55.1; P < .001). Our results indicated that social support, employment status, and degree of somatic complications cannot sufficiently explain the degree of emotional distress after transplantation. Subjective factors such as making sense of the transplantation in terms of regarding it as a worthwhile operation within the life course are important mediators of psychological stress and perceived quality of life.