Quality of life of candidates for and recipients of heart transplants.

OBJECTIVE

To describe the quality of life (QOL) of candidates for and recipients of heart transplants over a five-year period.

DESIGN

Descriptive, longitudinal.

SETTING

Canadian university-affiliated tertiary care medical centre.

PATIENTS

Sixty-five candidates for heart transplantation; after one year, six candidates were still awaiting transplantation; 42 patients received transplants and were included in the study six months post-transplant.

OUTCOME MEASURES

Three measures of QOL were used: the Index of Well-Being, Cantril's Self-Anchoring Striving Scale and the "time-trade-off technique'.

INTERVENTION

Data were collected before transplantation, six months post-transplantation, one year post-transplantation and annually for the next four years; for individuals who did not receive transplants, data were collected six months and one year after the first interview.

MAIN RESULTS

QOL scores were considerably higher after than before transplantation, and compared favourably with norms for the general population. For 11 individuals who did not receive transplants, QOL remained low. QOL for heart transplant recipients was remarkably stable over the five-year study period. The major predictors of QOL for candidates awaiting transplantation were health status, outlook and ability to work. After transplantation, the major predictors of QOL were outlook, health status and employment status.

CONCLUSIONS

There is evidence to suggest that QOL improves after heart transplantation, and that improvement is relatively stable over time. Further work is needed to identify the factors that could result in improvements in QOL.