Psychological aspects of heart transplantation

In the past, psychological problems associated with HTx have not been well documented. We have identified six stages of psychological adjustment associated with the initial hospitalization and eight problem areas that develop after the initial hospitalization. Our approach has been to utilize psychiatric services for the initial evaluation and for intervention on an individual basis. This approach was extended in June, 1983, to include a family members support group, and we are now planning a support group for the HTx patients. The data from our multicenter survey indicates that other centers in the United States and England have had similar experience with their HTx recipients. The approach has been a "traditional" one, and there are no support groups like the ones we created at this time, although several centers are in the planning stages of this type of therapy. This inquiry represents the first attempt to address the psychological problems associated with HTx. It is a first step in learning to treat these patients as a whole. However, many issues remain unaddressed because the methods of this investigation were subjective. The patient population has yet to be studied intensely to identify how it perceives its own problems, and how those problems evolve during prolonged survival, one to five years after HTx. Are these latter problems the same as those experienced during that first post-operative year? Lastly, if other centers organize support groups, it would be useful to form a network that would allow a patient to attend the group closest to his home when he leaves the HTx center.