Longitudinal Assessment of Psychosocial Readiness in Heart Transplant Candidates

By Maryjane Farr, M.D., M.Sc.

Professor of Internal Medicine
Section Chief, Heart Failure, LVAD, and Cardiac Transplantation

Psychosocial readiness for heart transplant is a CMS-required component of candidate selection. Multiple tools are available to measure a candidate’s mental health and socioeconomic resources and stressors in an attempt to predict which candidates are likely to be successful transplant recipients. These evaluations are performed at the time of candidate selection, but candidates are not typically reassessed in a standardized fashion while on the waitlist.

I collaborated with Audrey Kleet, D.N.P., Chief Heart Failure and Heart Transplant Nurse Practitioner at Columbia University, as part of her doctoral thesis, and with Carmen Alvarez, Ph.D., RN, CRNP, CNM, Associate Professor of Nursing at the Johns Hopkins Bloomberg School of Public Health, to implement a 12-week surveillance program of waitlisted heart transplant candidates. We sought to assess ongoing caregiver support, housing, transportation, insurance status, and levels of anxiety in potential heart transplant recipients.

In this study, which was presented at #AHA22, we found that nearly 25% of waitlisted heart transplant candidates required follow-up with a transplant social worker to address instability in psychosocial readiness. Most of these follow-up visits were needed to address mental health concerns in the transplant candidates. This study highlights that longitudinal surveillance of the psychosocial needs of waitlisted patients is feasible and worthwhile. Future studies are needed to determine whether such longitudinal assessments improve outcomes following heart transplantation.

Email: maryjane.farr@utsouthwestern.edu

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