[Preoperative evaluation of the body concept of donors and recipients of living kidney donations].

Objectives: The psychosocial evaluation of the body concept of living kidney donors and recipients is part of a general psychosocial assessment as well as the early detection of organ integration disorders.

Methods: From 2010 to 2011 we investigated the eligibility for living kidney donation in 36 living kidney donors and 36 recipients using a semistructured clinical interview and the German version of the Transplant Evaluation Rating Scale (TERS). In addition, we used the Fragebogen zum Körperbild (FKB-20) to evaluate body concept.

Recent trends in heart transplantation: the University of Vienna experience.

Since the beginning of the University of Vienna Cardiac Transplant Program in 1984, 1086 heart transplant procedures have been performed through the end of 2007. One- and five-year survival has increased steadily over time (82% and 76%). Ten-year survival is 65%.

Mechanical circulatory support as a bridge to heart transplantation: what remains? Long-term emotional sequelae in patients and spouses.

Background: Implantation of a ventricular assist device (VAD) reduces short-term mortality and morbidity and provides patients with reasonable quality of life even though it may also be a long-lasting emotional burden. This study was conducted to analyze the long-time emotional consequences of VAD implantation, followed by heart transplantation in patients and spouses.

Methods: This cross-sectional study used the Impact of Event Scale-Revised (IES-R) Version, recording avoidance, intrusion, and hyperarousal, to investigate symptoms of post-traumatic stress disorder (PTSD), and VAD-related fears and concerns.

Posttraumatic stress disorder after implantation of a mechanical assist device followed by heart transplantation: evaluation of patients and partners.

Aim: We sought to investigate the prevalence of posttraumatic stress disorder, anxiety, and depression in patients and their partners after implantation of a mechanical assist device as a bridge to heart transplantation.

Methods: This was a retrospective assessment of 41 patients (age 46.3 +/- 12.

The University of Vienna experience in heart transplantation.

Since the University of Vienna Cardiac Transplant Program began in 1984, 892 heart transplant procedures have been performed through the end of 2001. One- and five-year survival has increased steadily over time to 80% and 75%, respectively, in the most recent cohort. Ten-year survival is 55%.

[Survival, clinical data and quality of life 10 years after heart transplantation: a prospective study].

Aim: To study prospectively patients after heart transplantation with respect to quality of life, mortality, morbidity, and clinical parameters before and up to 10 years after the operation.

Methods: Sixty patients (47.9 +/- 10.

[Integration process and organ-related fantasies in patients undergoing organ transplantation].

This review deals with an important aspect of organ transplantation, namely the process of psychic organ integration and organ-related fantasies. The body schema and body self are two important concepts in the integration of a transplanted organ. Different models and theories on organ integration are presented and will be discussed.

[Changes in partner relationship after organ transplantation: comparison between heart, liver, and kidney transplantation].

Aim: This study was conducted to delineate partnership-relation functioning over time and specifically matched to various organs such as heart, liver, and kidney.

Method: Prospective, paralleled case-control-study including patients and their respective partners before and one year after organ transplantation in 23 heart-transplant recipients, 19 liver-transplant patients, and 16 kidney-transplant recipients. To assess partnership functioning, the FB-Z (family assessment measure) of Cierpka and Frevert was used.

Noncompliance in organ transplant recipients: a literature review.

The consequences of failing to comply to doctor's instructions can be damaging and devastating for the individual patient and their family. Noncompliance also leads to waste, as it reduces the potential benefits of therapy, and to the extra cost of treating avoidable consequent morbidity. Life-long immunosuppression is a prerequisite for good graft function, and noncompliance is often associated with late acute rejection episodes, graft loss, and death.

Solid organ transplantation: are there predictors for posttransplant noncompliance? A literature overview.

Background: Many studies confirm that noncompliance or poor compliance is one of the great problems in health care as it results in waste of resources and funds.

Methods: This overview includes literature on heart, liver, and kidney transplants with emphasis on heart transplantation in adult and pediatric transplant patients and addresses the following variables as potential predictors of postoperative compliance problems: demographic variables (age, marital status, gender) psychological variables (anxiety, denial) psychiatric disorders (major depression, anxiety, and personality disorders), poor social support, pretransplant noncompliance, obesity, substance abuse, and health-related variables (distance from transplant center, indication for transplantation, required pretransplant assist device). Relevant studies on these topics that were conducted up to 1999 are included and discussed in this overview.

[Noncompliance in organ transplantation: a review].

The effectiveness of medical treatment depends not only on the appropriateness of the treatment modality but also on the patient's compliance with the intended regimen. The consequences of failing to comply can be damaging and devastating for the individual patient and his/her family. Noncompliance also leads to waste in two areas: first, a reduction of the potential benefits of therapy, and second, the additional cost of treating the avoidable consequent morbidity.

Long-term effects of heart transplantation: the gap between physical performance and emotional well-being.

The purpose of our study was to assess physical and emotional factors in heart transplant patients. A prospective design was used to compare patients' physical symptoms, emotional complaints, and restrictions at admission to the waiting list, immediately after, and 1 and 5 years after heart transplantation. Thirty-three patients were included (30 male, 3 female) in the study.

Patients benefit--partners suffer? The impact of heart transplantation on the partner relationship.

Terminal heart disease affects not only the patient, but also members of the patient's family, and especially the spouse. The aim of this prospective study of 26 couples was to collect information about the impact of heart transplantation on the partner relationship. Data were collected from patients and spouses when the patients were placed on the waiting list for transplantation, 1 year postoperatively, and 5 years postoperatively.

Cyclosporine may affect improvement of cognitive brain function after successful cardiac transplantation.

Background: The effects of cardiac transplantation on cognitive brain function are uncertain.

Methods And Results: We measured cognitive brain function and quality of life in out-of-hospital cardiac transplant candidates (n = 55; ejection fraction, 19.9%; age, 54.

Acceptance of a pump-driven infusion therapy with prostaglandin E1 as a bridge to heart transplantation.

Ambulatory pump-driven intravenous infusions are a novel and - compared with hospitalization-cost-effective procedure to bridge refractory heart failure patients to cardiac transplantation. In the present study 13 patients received chronic infusions with prostaglandin E1 alone or in conjunction with catecholamines and the acceptance of this bridging therapy was investigated over a period of seven weeks. Prostaglandin E1 was uptitrated from 2.

[Heart transplantation: psychosocial correlations in the postoperative period].

Heart transplantation offers not only increased quantity but also highly improved quality of life. Nevertheless, it should not be seen as a panacea. Postoperatively the patients and their spouses face and have to overcome profound psychosocial problems.

[Heart transplantation and sexuality. A study of 62 male patients].

119 adult male Austrian patients who had undergone heart transplantation between January 1985 and December 1990 were questioned on sexual functional disorders pre- and postoperatively. Questions dealt with perceived medication effects on sexual function and libido, fear of intercourse, their worries about the sexual habits of the donor, perceived changes in sexual attractiveness and body image. They were also asked how they felt about discussing sexual matters with their doctors.

Heart transplantation: are there psychosocial predictors for clinical success of surgery?

50 adult patients were extensively psychosocially examined before undergoing heart transplantation. The data obtained and the clinical treatment data were compared with the clinical success of surgery (four groups ranging from excellent to unsatisfactory as determined by the surgeon one year after transplantation). Statistical evaluation by discriminant analysis resulted in the following predictors for successful surgery (all psychosocial): empathy, care and support by one partner (affective involvement), few demands for emotional communication (affective expression), self-control, ability to take stress, emotional stability, high frustration tolerance, low aggression level, and younger age.

Psychosocial problems of donor heart recipients adversely affecting quality of life.

Heart transplantation has become an accepted therapy for patients suffering from terminal heart disease for whom neither standard forms of medication nor the usual surgery are of any benefit. Although results regarding postoperative quantity and quality of life are encouraging, it must not be overlooked that the patient and his family face, and have to overcome, profound psychosocial problems. The main stressors were identified in interviews with 47 heart transplant patients.

Does changing the heart mean changing personality? A retrospective inquiry on 47 heart transplant patients.

Heart transplantation is not simply a question of replacing an organ that no longer functions. The heart is often seen as source of love, emotions, and focus of personality traits. To gain insight into the problem of whether transplant patients themselves feel a change in personality after having received a donor heart, 47 patients who were transplanted over a period of 2 years in Vienna, Austria, were asked for an interview.

["You need a new heart". The problem of diagnostic disclosure from the viewpoint of the affected cardiologic patient].

Heart transplantation has become a reasonable therapeutic option in treatment of patients with terminal heart diseases. Though it offers increased quantity as well as improved quality of life, information about needing a donor heart is a turning point in the patient's life. The aim of the study was to evaluate through postoperative interviews how that information was given by the doctors and how the patients had coped with it.