BACKGROUND: Research examining age differences after heart transplant (HT) has focused primarily on morbidity and mortality outcomes, with little emphasis on potential age differences in quality of life and psychosocial outcomes. The objective of the study was to determine whether older patients have more positive adjustment and quality of life several years after HT compared with younger patients. METHODS: The study recruited 555 patients who were at least 5 years post-HT from 4 United States medical centers. The sample included 165 older patients (≥ 60 years at HT), 300 middle-aged patients (between 45 and 59 years), and 90 younger patients (< 45 years). Of these, 78% were men, 88% were white, and most were well educated (14.04 mean years of education). Outcome measures examined quality of life, social support, mood, coping strategies, stress, health functioning, and adherence. Hypotheses regarding outcomes were derived from incidental findings from the original study. RESULTS: Statistics included multivariate analyses of covariance, followed by univariate analyses of covariance that controlled for differences in sex, race, years of education, and marital status. Older HT patients were more satisfied with quality of life (p < 0.001) and social support (p = 0.003), had less HT-related stress (p < 0.001), negative affect (p < 0.001), depression (p < 0.001), better overall functioning (p = 0.035), less use of negative coping strategies (p = 0.006), less difficulty with adherence (p < 0.001), and better actual adherence (p < 0.001) than younger and middle-aged HT patients. CONCLUSIONS: Older patients in this large sample had better quality of life, psychosocial adjustment, and adherence after HT than middle-aged and younger patients. If replicated, this age advantage should at least be considered when assessing age as a criterion for HT clinical decision making and organ allocation policy.
BACKGROUND: Research examining age differences after heart transplant (HT) has focused primarily on morbidity and mortality outcomes, with little emphasis on potential age differences in quality of life and psychosocial outcomes. The objective of the study was to determine whether older patients have more positive adjustment and quality of life several years after HT compared with younger patients. METHODS: The study recruited 555 patients who were at least 5 years post-HT from 4 United States medical centers. The sample included 165 older patients (≥ 60 years at HT), 300 middle-aged patients (between 45 and 59 years), and 90 younger patients (< 45 years). Of these, 78% were men, 88% were white, and most were well educated (14.04 mean years of education). Outcome measures examined quality of life, social support, mood, coping strategies, stress, health functioning, and adherence. Hypotheses regarding outcomes were derived from incidental findings from the original study. RESULTS: Statistics included multivariate analyses of covariance, followed by univariate analyses of covariance that controlled for differences in sex, race, years of education, and marital status. Older HT patients were more satisfied with quality of life (p < 0.001) and social support (p = 0.003), had less HT-related stress (p < 0.001), negative affect (p < 0.001), depression (p < 0.001), better overall functioning (p = 0.035), less use of negative coping strategies (p = 0.006), less difficulty with adherence (p < 0.001), and better actual adherence (p < 0.001) than younger and middle-aged HT patients. CONCLUSIONS: Older patients in this large sample had better quality of life, psychosocial adjustment, and adherence after HT than middle-aged and younger patients. If replicated, this age advantage should at least be considered when assessing age as a criterion for HT clinical decision making and organ allocation policy.
Authors: Connie White-Williams; Kathleen L Grady; David C Naftel; Susan Myers; Edward Wang; Bruce Rybarczyk Journal: Clin Transplant Date: 2012-12-30 Impact factor: 2.863
Authors: Emily M Rosenberger; Kristen R Fox; Andrea F DiMartini; Mary Amanda Dew Journal: Curr Opin Organ Transplant Date: 2012-10 Impact factor: 2.640
Authors: Kathleen L Grady; David C Naftel; Susan Myers; Mary Amanda Dew; Gerdi Weidner; John A Spertus; Katharine Idrissi; Hochang B Lee; Edwin C McGee; James K Kirklin Journal: J Heart Lung Transplant Date: 2014-10-31 Impact factor: 10.247
Authors: Tasmeen Hussain; Keira Nassetta; Linda C O'Dwyer; Jane E Wilcox; Sherif M Badawy Journal: Transplant Rev (Orlando) Date: 2021-09-20 Impact factor: 3.943
Authors: Kathleen L Grady; Andrew Kao; John A Spertus; Eileen Hsich; Mary Amanda Dew; Duc-Thinh Pham; Justin Hartupee; Michael Petty; William Cotts; Salpy V Pamboukian; Francis D Pagani; Brent Lampert; Maryl Johnson; Margaret Murray; Koji Takeda; Melana Yuzefpolskaya; Scott Silvestry; James K Kirklin; Adin-Cristian Andrei; Christian Elenbaas; Abigail Baldridge; Clyde Yancy Journal: Circ Heart Fail Date: 2022-10-10 Impact factor: 10.447
Authors: Kathleen L Grady; Edward Wang; Connie White-Williams; David C Naftel; Susan Myers; James K Kirklin; Bruce Rybarczyk; James B Young; Dave Pelegrin; Jon Kobashigawa; Robert Higgins; Alain Heroux Journal: J Heart Lung Transplant Date: 2013-04 Impact factor: 10.247
Authors: Kathleen L Grady; Adin-Cristian Andrei; Christian Elenbaas; Anna Warzecha; Abigail Baldridge; Andrew Kao; John A Spertus; Duc-Thinh Pham; Mary Amanda Dew; Eileen Hsich; William Cotts; Justin Hartupee; Salpy V Pamboukian; Francis D Pagani; Michael Petty; Brent Lampert; Maryl Johnson; Margaret Murray; Koji Takeda; Melana Yuzefpolskaya; Scott Silvestry; James K Kirklin; Clyde Yancy Journal: J Am Heart Assoc Date: 2022-02-12 Impact factor: 6.106