Contact: Christine E. Skotzko, MD, FAPM
Phone: (732) 235-7647
Email: skotzkce@umdnj.edu
Embargoed until: March 16, 2002

BARCELONA, SPAIN-- The prospect of cardiac transplantation places individuals who need to undergo this procedure in an untenable situation. In selecting candidates for this exceptionally scarce and valuable resource, a great deal of attention is paid to the individual's ability to be adherent to a rigorous medical regimen.

In selecting candidates for cardiac transplantation transplant centers evaluate potential medical, surgical, and psychosocial variables, which may place the individuals at increased risk for morbidity and mortality post cardiac transplantation.

A study by investigators at UMDNJ-RWJMS, New Brunswick, New Jersey demonstrated that comprehensive pre-transplant assessment can predict individuals whose psychosocial factors place them at increased risk for medical morbidity after transplantation. The results of the study were presented for the first time at the American Psychosomatic Society Annual Meeting, held March 13-16 in Barcelona, Spain.

Candidates for cardiac transplantation were assigned to low, moderate, or high psychosocial risk category preoperatively as part of their comprehensive preoperative psychosocial assessment. Individuals who were listed and subsequently, transplanted were followed for episodes of graft rejection, infection, and subsequent hospitalizations. Those in the moderate to high-risk groups had significantly higher rates of rejection and hospitalizations, and trended towards more infections and higher mortality than the low risk group.

This work provides hope that further evaluation of psychosocial risk factors preoperatively can guide interventions to improve candidacy and, hopefully, outcomes post-cardiac transplantation. It demonstrates that psychosocial assessment can identify "at risk" individuals. With cooperation across centers there is the potential to develop interventions that may assist individuals to improve their ability to handles the challenges associated with transplantation and ultimately improve their medical outcomes.

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