IMPACT OF PSYCHOLOGIC FUNCTIONING, MEDICAL SEVERITY, AND FAMILY FUNCTIONING IN PEDIATRIC HEART-TRANSPLANTATION

Background and Methods: This study examined (1) the psychologic functi oning of children and adolescents before and after heart transplantati on and (2) whether pretransplantation psychologic functioning, posttra nsplantation medical severity, and family functioning were related to the patients' posttransplantation psychologic functioning. The subject s were 23 patients, ages 3 to 20 years, who underwent heart transplant and survived at least 1 year after their transplantation. Psychologic functioning was assessed by the Children's Global Assessment Scale be fore and after heart transplantation. Medical severity was assessed by number of outpatient visits, hospitalizations, biopsies, and the Side Effect Severity Scale. Family functioning was rated on the Global Ass essment of Family Relational Functioning Scale. Results: The majority of the patients (78.3%) had good psychologic functioning after their h eart transplantation. Patients with psychologic difficulties before an d after transplantation had more hospitalizations after transplantatio n.Conclusions: Pretransplantation emotional functioning and family fun ctioning were more correlated with posttransplantation psychologic fun ctioning than medical side effect severity.