Impact of cardiac transplantation on the spouse's life

Article Abstract:

Heart transplantation is a stressful procedure for both the patient and the patient's family. During the waiting period and again after the transplant, family roles change. Anxiety and stress are common, with the additional factor that the patient is waiting for someone to die to provide a heart, and there is no way to know whether a suitable organ will be found in time to save the patient's life. Posttransplant quality of life is also a concern. To measure the effects of this uncertainty on the spouse, the Perception of Heart Transplantation Questionnaire (PHTQ) was developed and administered to 30 spouses of heart transplant patients, along with the Subjective Stress Scale (SSS) and a demographic-illness data form. The results showed the immense impact on the spouse of the waiting period before transplantation, which may have been intensified by the perceived uncertainty. However, uncertainty is not limited to the pretransplant period, so it probably did not unduly affect the results. Spouses described this period as one of being in ''limbo.'' The stress scores between the pre- and posttransplant periods were not significantly different, although there were more positive feelings afterward. It may be that recollection of stress during the pretransplant period was limited. Not surprisingly, spouses feared the patient's death most, but after the transplant the degree of acceptance of risk increased. During both periods there was a strong need to learn more about transplantation, although other studies have found that waiting patients and families ignored pretransplant information. This finding may reflect the spouse's later perception of the need rather than the actual attitude at the time. Life in general was greatly influenced by the transplant, perhaps in part because from then on, survival would depend on adherence to a strict medical regimen, but also because potential complications, frequent medical follow-ups, and a substantial financial commitment added to uncertainty. ''Normal'' life is not a realistic expectation after such a procedure. Health care providers must remember that illness affects not only the patient, but the whole family, and family adjustment will have an impact on the outcome. An encouraging staff, support groups, and ongoing assessment of the spouse's need to have information about the illness will all help the patient's family to adjust and to maintain realistic expectations. (Consumer Summary produced by Reliance Medical Information, Inc.)

---

Heart transplantation may not improve quality of life for patients with stable heart failure

Article Abstract:

For some patients with chronic heart failure, heart transplantation is a therapeutic option. Since many patients waiting for transplants can be successfully maintained with stabilizing medical therapy, transplantation may no longer be indicated for them. To assess the benefits of transplantation after symptoms have improved with medical therapy, the quality of life for 24 transplant patients and 20 patients managed with vigorous medical therapy were compared. Social, intellectual, and emotional functioning was determined by evaluating the patients' ability to perform routine activities. Economic stability, employment status, general well-being and satisfaction with life, perceived physical symptoms, and personal views regarding health were assessed. Three questionnaires that were used included the Multiple Affect Adjective Check list (MAACL), the Psychosocial Adjustment to Illness Scale (PAIS), and a functional status assessment questionnaire. Although transplantation increased survival, the quality of life and the functional status of the patient did not improved. Psychosocial functioning was the same for both transplant recipients and patients receiving medical therapy. With the shortage of available heart donors, recommendation for heart transplantation may be questionable if patients receiving medical therapy for heart failure have a similar quality of life when compared with those who receive transplants. Patients and their families should be made aware that surgery may not improved the quality of life. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Quality of life

---

Using OKT3 to reverse cardiac allograft rejection

Article Abstract:

Heart transplant recipients must take drugs that suppress the immune system to prevent organ rejection. Side effects produced by current immunosuppressive agents may necessitate a reduction in dosage. When dosages are lowered, immunosuppression may not be adequate to maintain the graft. A new agent, OKT3, has recently been approved for treatment of transplant rejection. OKT3 works by inhibiting specialized white blood cells involved in the immune response. During OKT3 clinical trials, seizures, lung swelling, and water overload were commonly reported. Out of 11 transplant recipients in this study, 10 had transplant rejection reversed with OKT3. Side effects included fever, diarrhea, nausea, vomiting, joint pain (from the destruction of white blood cells), infection, and low blood pressure. Critical care nurses should be aware of the potential side effects and should monitor breathing patterns, blood pressure and temperature, replace fluid loss from vomiting or diarrhea, reduce joint pain with anti-inflammatory agents, employ careful infection control measures, and watch for potential seizure activity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Research, Usage, Drug therapy, Graft rejection, Immunosuppressive agents, OKT3, Muromonab-CD3

Similar abstracts:

• Abstracts: The long and the short of sleeping pills. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure
• Abstracts: Reversal by liver transplantation of the complications of primary hyperoxaluria as well as the metabolic defect
• Abstracts: Comparison of standard and low serum levels of lithium for maintenance treatment of bipolar disorder. Prospective study of tardive dyskinesia incidence in the elderly
• Abstracts: Effect of restricting dietary protein on the progression of renal failure in patients with insulin-dependent diabetes mellitus
• Abstracts: Hypertension after renal transplantation in patients treated with cyclosporin and azathioprine. Polyvalent immune globulin and cytomegalovirus infection after renal transplantation

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.