Life quality in the era of bridging to cardiac transplantation. Bridge patients in an outpatient setting.

This study provides an empirical evaluation of quality of life in the first two heart transplant candidates with mechanical circulatory support who were transferred (with support in place) to an outpatient setting to await transplantation. Their life quality in physical, emotional, and social domains following transfer was compared to: 1) their previous life quality while hospitalized, 2) life quality among a case series of five other candidates awaiting transplantation during the same time period, and 3) life quality among recent samples of heart recipients from our center and elsewhere. The transferred patients improved markedly in physical and emotional well being, with smaller gains in social functioning after leaving the hospital. They not only improved over their own earlier status while hospitalized, but showed life quality advantages over other hospitalized transplant candidates. Overall, they came to more closely resemble transplant recipients, rather than candidates, of similar age and indication for transplant. Outpatient care for selected mechanically supported heart transplant candidates provides an important potential option for the increasing numbers of patients requiring such support for extended time periods. The study yields critical data as fully implantable mechanical circulatory support devices for permanent heart replacement become a possibility.