Functional and Social Rehabilitation of Heart Transplant Recipients Under Age Thirty

Abstract

In the Stanford Heart transplant program, the functional and social rehabilitation of heart transplant recipients below the age of thirty has been investigated by using data from annual follow-ups with right and left heart catheterization, left ventricular (LV) and coronary angiograms and by a health survey questionnaire investigation. 24 out of 38 patients who received transplants in the period January 1, 1974 to April 1981 were still alive. The actuarial survivalrates in this group of patients are: 3 months 74%, 1 year 71%, 3 years 67%, 5 years 50%. The figures are persistently higher than for the total number of heart transplant recipients in the Stanford program. 71% of the fatalities occurred during the critical first 3 months after tranplantation. The hemodynamic and angiographic findings were normal in all but 2 patients where progressive coronary artery disease had been diagnosed. 23 out of the 24 patients completed the questionnaire. 9 patients were back at work, 4 went to school as required, 4 were now postgraduate students, 2 studied for self-satisfation and 4 patients neither worked nor studied. All patients considered themselves able to do some kind of work. All patients were able to walk at least 1 mile and 70% 3 miles. 87% were able to do heavy domestic work. Hardly any restrictions in transportation ability and mostly minor restrictions in the activities of daily living were found. Marital satisfaction and sexual function were good in most of the patients; 57% were very satisfied, 30% moderately satisfied and 13% not really satisfied with their life. 96% would make the same choice and accept a heart transplantation if they had to make the decision again.