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Published on: August 15, 2022
Psychological distress and cause-specific readmissions during early recovery after lung transplantation: A
Xiaoling Mou1, Jiajia Huang1, Jinfeng Qin1
1Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
Background:
Early recovery after lung transplantation involves psychological distress, symptom burden, functional limitations, and recurrent readmissions. We examined whether anxiety and depressive symptom severity were differentially associated with graft-related and surgery-related recurrent readmissions during the first 6 months after transplantation.
Methods:
In this prospective single-center cohort, 74 adult lung transplant recipients completed assessments at 1, 3, and 6 months. Anxiety, depressive symptoms, health-related quality of life, and transplant-related symptoms were assessed using validated instruments. Readmissions were adjudicated by principal discharge diagnosis and analyzed as recurrent events using mean cumulative function curves and multivariable Poisson regression with follow-up time as an offset.
Results:
At 6 months, mean cumulative readmission burden was 0.39 events per patient for graft-related readmissions and 0.26 for surgery-related readmissions. Anxiety severity grade was associated with graft-related readmission (incidence rate ratio [IRR], 1.63; 95% confidence interval [CI], 1.08-2.48), whereas depressive symptom severity was associated with surgery-related readmission (IRR, 2.81; 95% CI, 1.20-6.59). Physical Functioning improved from 22.5 to 72.5, whereas psychological recovery and symptom resolution were more gradual.
Conclusions:
During the first 6 months after lung transplantation, anxiety and depressive symptom severity were associated with different cause-specific recurrent readmission profiles. These interval-level associations indicate clinically relevant recovery vulnerability rather than temporal causation. Brief GAD-7 and PHQ-9 screening may add context to symptom assessment and clinical surveillance during early follow-up.