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Heart Transplantation

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Handbook of Cardiovascular Behavioral Medicine

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Abstract

Since the first successful orthotopic heart transplant in 1967, medical, surgical, and technological advances have transformed cardiac transplantation into a realistic endpoint for many patients with terminal cardiac disease. Currently, over 2000 transplants are performed annually in the United States, although a scarcity of organs, among other factors, results in 10–15% of candidates dying while on the waiting list. This chapter examines the behavioral and mental health issues associated with heart transplantation, including the opportunities for mental health interventions. Topics include a review of psychiatric comorbidities such as depression and anxiety, as well as management approaches related to congestive heart failure/end-stage heart disease, ventricular assist devices, and heart transplantation itself, including a discussion of the psychological implications related to internalization of a foreign organ. It also describes the pre-transplant psychosocial evaluation process and explores post-transplant areas of concern, such as drug-drug side effects and many of the challenges of post-transplant life, including adherence to medication and treatment.

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References

  1. Bechstein W (2000) Neurotoxicity of calcineurin inhibitors: impact and clinical management. Transpl Int 13:313–326

    Article  PubMed  Google Scholar 

  2. Berkman LFBJ, Burg M, Carney RM, Catellier D, Cowan MJ, Czajkowski SM, DeBusk R, Hosking J et al (2003) Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the enhancing recovery in coronary heart disease patients (ENRICHD) randomized trial. JAMA 289:3106–3116

    Article  PubMed  Google Scholar 

  3. Bunzel BL-HK, Wieselthaler GM, Roethy W, Drees G (2005) Posttraumatic stress disorder after implantation of a mechanical assist device followed by heart transplantation: evaluation of patients and partners. Transplant Proc 37:1365–1368

    Article  PubMed  Google Scholar 

  4. Castelnuovo-Tedesco P (1978) Ego vicissitudes in response to replacement or loss of body parts. Certain analogies to events during psychoanalytic treatment. Psychoanal Q 47:381–397

    Article  PubMed  Google Scholar 

  5. Chacko RCHR, Kunik M, Young J (1996) Relationship of psychiatric morbidity and psychosocial factors in organ transplant candidates. Psychosomatics 37:100–107

    Article  PubMed  Google Scholar 

  6. Crone CCGG (2004) Treatment of anxiety and depression in transplant patients: pharmacokinetic considerations. Clin Pharmacokinet 43:361–394

    Article  PubMed  Google Scholar 

  7. De Bleser LMM, Dobbels F, Russell C, De Geest S (2009) Interventions to improve medication-adherence after transplantation: a systematic review. Transpl Int 22:780–797

    Article  PubMed  Google Scholar 

  8. Dew MARL, Schulberg HC, Simmons RG, Kormos RL, Trzepacz PT, Griffith BP (1996) Prevalence and predictors of depression and anxiety-related disorders during the year after heart transplantation. Gen Hosp Psychiatry 18:48S–61S

    Article  PubMed  Google Scholar 

  9. Dew MAKR, Roth LH et al (1999) Early post-transplant medical compliance and mental health predict physical morbidity and mortality one to three years after heart transplantation. J Heart Lung Transplant 18:549–562

    Article  PubMed  Google Scholar 

  10. Dew MAKR, DiMartini AF, Switzer GE, Schulberg HC, Roth LH, Griffith BP (2001) Prevalence and risk of depression and anxiety -related disorders during the first three years after heart transplantation. Psychosomatics 42:300–313

    Article  PubMed  Google Scholar 

  11. Dew MAKR, Winowich S, Harris RC, Stanford EA, Carozza L, Griffith BP (2001) Quality of life outcomes after heart transplantation in individuals bridged to transplant with ventricular assist devices. J Heart Lung Transplant 20:1199–1212

    Article  PubMed  Google Scholar 

  12. Dew MAML, Switzer GE, DiMartini AF, Schulberg HC, Kormos RL (2005) Profiles and predictors of the course of psychological distress across four years after heart transplant. Psychol Med 35:1215–1227

    Article  PubMed  Google Scholar 

  13. Dew DA, De Vito Dabbs A et al (2007) Rates and risk factors for nonadherence to the medical regimen after adult solid organ transplantation. Transplantation 83:858–873

    Article  PubMed  Google Scholar 

  14. Dew MA, Steel J et al (2008) Meta-analysis of risk for relapse to substance use after transplantation of the liver or other solid organs. Liver Transpl 14:159–172

    Article  PubMed  PubMed Central  Google Scholar 

  15. DiMarco JP (2003) Implantable cardioverter-defibrillators. N Engl J Med 349:1836–1847

    Article  PubMed  Google Scholar 

  16. DiMartini AFDM, Trzepacz PT (2005) Organ transplantation. In: JL L (ed) Textbook of psychosomatic medicine. American Psychiatric Publishing Inc, Washington, DC

    Google Scholar 

  17. Epstein AEDJ, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, Gillinov AM et al (2008) ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. J Am Coll Cardiol 51:1–62

    Article  Google Scholar 

  18. Fusar-Poli PPM, Martinelli V, Bhattacharyya S, Cortesi M, Barale F, Polit P (2006) Anti-depressive therapies after heart transplantation. J Heart Lung Transplant 25:785–792

    Article  PubMed  Google Scholar 

  19. Glassman AHOCC, Califf RM, Swedberg K, Schwartz P et al (2002) Sertraline treatment of major depression in patients with acute MI or unstable angina: sertraline antidepressant heart attack randomized trial. JAMA 288:701–709

    Article  PubMed  Google Scholar 

  20. Grimm MYW, Laufer G, Madl C, Kramer L, Eisenhuber E, Simon P, Kupilik N et al (1996) Cyclosporine may affect improvement of cognitive brain function after successful cardiac transplantation. Circulation 94:1339–1345

    Article  PubMed  Google Scholar 

  21. Havik OESB, Relbo A, Hellesvik M, Grov I, Geiran O, Andreassen AK, Simonsen S, Gullestad L (2007) Depressive symptoms and all-cause mortality after heart transplantation. Transplantation 84:97–103

    Article  PubMed  Google Scholar 

  22. Irvine JDP, Baker B et al (2002) Quality of life in the Canadian Implantable Defibrillator Study (CIDS). Am Heart J 144:282–289

    Article  PubMed  Google Scholar 

  23. Laederach-Hofmann KBB (2000) Noncompliance in organ transplant recipients: a literature review. Gen Hosp Psychiatry 22:412–424

    Article  PubMed  Google Scholar 

  24. Lazar RM, Shapiro PA, Jaski BE, Parides MK, Bourge RC et al (2004) Neurological events during long-term mechanical circulatory support for heart failure: the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) experience. Circulation 109:2423–2427

    Article  PubMed  Google Scholar 

  25. Lesperance FF-SN, Koszycki D et al (2007) Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: the Canadian cardiac randomized evaluation of antidepressant and psychotherapy efficacy (CREATE) trial. JAMA 297:367–379

    Article  PubMed  Google Scholar 

  26. Lossnitzer NM-TT, Lowe B, Zugck C, Nelles M, Remppis A, Haass M, Rauch B, Junger J, Herzog W, Wild B (2009) Exploring potential associates of suicidal ideation and ideas of self-harm in patients with congestive heart failure. Depress Anxiety 26:764–768

    Article  PubMed  Google Scholar 

  27. Mago RGJ, Gupta N, Kunkel EJS (2006) Anxiety in medically ill patients. Curr Psychiatry Rep 8:228–233

    Article  PubMed  Google Scholar 

  28. Maldonado JR, Dubois HC, David EE, Sher Y, Lolak S, Dyal J, Witten D (2012) The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT): a new tool for the psychosocial evaluation of pre-transplant candidates. Psychosomatics 53:123–132

    Article  PubMed  Google Scholar 

  29. Moss AJHW, Cannom DS, Daubert JP, Higgins SL, Klein H et al (1996) Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia: multi-center automatic defibrillator implantation trial investigators. N Engl J Med 335:1933–1940

    Article  PubMed  Google Scholar 

  30. Moss AJZW, Hall WJ, Klein H, Wilber DJ, Cannom DS et al (2002) Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 346:877–883

    Article  PubMed  Google Scholar 

  31. Muzyk AJHS, Gagliardi JP (2010) Corticosteroid psychosis: stop therapy or add psychotropics? Curr Psychiatry 9:61–69

    Google Scholar 

  32. Olbrisch MELJ, Hamer R (1989) The PACT: a rating scale for the study of clinical decision-making in psychosocial screening of organ transplant candidates. Clin Transpl 3:164–169

    Google Scholar 

  33. Owen JEBC, Wellisch DK (2006) Psychiatric evaluations of heart transplant candidates: predicting post-transplant hospitalizations, rejection episodes, and survival. Psychosomatics 47:213–222

    Article  PubMed  Google Scholar 

  34. Pudlo RPM, Zakliczynski M, Zembala M (2009) The occurrence of mood and anxiety disorders in heart transplant recipients. Transplant Proc 41:3214–3218

    Article  PubMed  Google Scholar 

  35. Rose EAGA, Moskowitz AJ et al (2001) Long-term mechanical circulatory support for end stage heart failure: the REMATCH trial. N Engl J Med 345:1435–1443

    Article  PubMed  Google Scholar 

  36. Sabate E (2003) World Health Organization report: adherence to long-term therapies. Evidence for action. World Health Organization

    Google Scholar 

  37. Schron EBED, Yao Q et al (2002) Quality of life in the antiarrhythmics versus implantable defibrillators trial: impact of therapy and influence of adverse symptoms and defibrillator shocks. Circulation 105:589–594

    Article  PubMed  Google Scholar 

  38. Shapiro PA (1990) Life after heart transplantation. Prog Cardiovasc Dis 32:405–418

    Article  PubMed  Google Scholar 

  39. Shapiro P (2007) Treatment of depression in patients with congestive heart failure. Heart Fail Rev

    Google Scholar 

  40. Shapiro PA, Kornfeld DS (1989) Psychiatric outcome of heart transplantation. Gen Hosp Psychiatry 11:352–357

    Article  PubMed  Google Scholar 

  41. Shapiro PA, Williams DL, Foray AT, Gelman IS, Wukich N et al (1995) Psychosocial evaluation and prediction of compliance problems and morbidity after heart transplantation. Transplantation 60:1462–1466

    Article  PubMed  Google Scholar 

  42. Shapiro PA, Levin HR, Oz MC (1996) Left ventricular assist devices. Psychosocial burden and implications for heart transplant programs. Gen Hosp Psychiatry 18:30S–35S

    Article  PubMed  Google Scholar 

  43. Stukas AADM, Switzer GE, DiMartini A, Kormos RL, Griffith BP (1999) PTSD in heart transplant recipients and their primary family caregiver. Psychosomatics 40:212–221

    Article  PubMed  Google Scholar 

  44. Sullivan MDLW, Crane BA, Russo JE, Spertus JA (2004) Usefulness of depression to predict time to combined end point of transplant or death for outpatients with advanced heart failure. Am J Cardiol 94:1577–1580

    Article  PubMed  Google Scholar 

  45. Surman OSPR (1992) Reevaluation of organ transplantation criteria: allocation of scarce resources to borderline candidates. Psychosomatics 33:202–212

    Article  PubMed  Google Scholar 

  46. Surman OSCA, Di Martini A (2009) Psychiatric care of patients undergoing organ transplantation. Transplantation 87:1753–1761

    Article  PubMed  Google Scholar 

  47. Terracciano CMML, Yacoub MH (2010) Contemporary use of ventricular assist devices. Annu Rev Med 61:255–270

    Article  PubMed  Google Scholar 

  48. Twillman RKMC, Wellisch DK, Wolcott DL (1993) The transplant evaluation rating scale: a revision of the psychosocial levels system for evaluating organ transplant candidates. Psychosomatics 34:144–153

    Article  PubMed  Google Scholar 

  49. UNOS. http://optn.transplant.hrsa.gov/latestData/rptData.asp

  50. van den Brink RH, Honig A, Schene AH, Crijns HJ, Lambert FP, Ormel J (2002) Treatment of depression after myocardial infarction and the effects on cardiac prognosis and quality of life: rationale and outline of the myocardial INfarction and depression-intervention trial (MIND-IT). Am Heart J 144:219–225

    Article  PubMed  Google Scholar 

  51. Warrington TPBJ (2006) Psychiatric adverse effects of corticosteroids. Mayo Clin Proc 81:1361–1367

    Article  PubMed  Google Scholar 

  52. Yates WRBB, Reed DA et al (1993) Descriptive and predictive validity of a high-risk alcoholism relapse model. J Stud Alcohol 54:645–651

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA

    Sara S. Nash

  2. Department of Psychiatry, Columbia University Medical Center, New York, NY, USA

    Peter A. Shapiro

Authors
  1. Sara S. Nash
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  2. Peter A. Shapiro
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Corresponding author

Correspondence to Sara S. Nash .

Editor information

Editors and Affiliations

  1. Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, USA

    Shari R. Waldstein

  2. Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands

    Willem J. Kop

  3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    Edward C. Suarez

  4. Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    William R. Lovallo

  5. Division of Gerontology Geriatrics and Palliative Medicine Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Leslie I. Katzel

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Nash, S.S., Shapiro, P.A. (2022). Heart Transplantation. In: Waldstein, S.R., Kop, W.J., Suarez, E.C., Lovallo, W.R., Katzel, L.I. (eds) Handbook of Cardiovascular Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-85960-6_53

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