Psychiatric distress during stages of the heart transplant protocol.

Psychiatric observations are reported on 101 heart transplant candidates (40 of whom had transplantations). Emotional responses were recorded during the evaluation, during the waiting period, perioperatively, at biopsy, during rejection episodes, and before and after discharge. Those phenomena, with the exception of behavioral management problems, were unrelated to initial psychiatric diagnoses; the diagnoses often reflected emotional reaction to cardiac illness. Most distress after evaluation appeared to be related to the protocol rather than to preexisting psychopathology. The stage of the protocol affected the nature of the reactions. Psychiatric assistance aided the adjustment process.