Facebook Twitter YouTube

Quality of Life Following Pediatric Heart Transplant: Are Age and Activity Level Factors?

Saturday, October 20, 2012: 11:15 AM
Room 275-277 (Morial Convention Center)
John Jerry Parent, MD1, Eric S. Ebenroth, MD2, Lauren E. Sterrett2, Marcus S. Schamberger, MD2, Robert K. Darragh3, Randall L. Caldwell3 and Debbie Murphy3, (1)Pediatric Cardiology, Indiana University School of Medicine, Indianapolis, IN, (2)Pediatrics, Section of Pediatric Cardiology, Riley Hospital for Children, Indianapolis, IN, (3)Pediatric Cardiology, Indiana University, Indianapolis, IN

Purpose: Few studies have reported quality of life (QoL) following heart transplant (HTx) in children.  We evaluated QoL in children post-HTx compared to previously reported QoL in children with congenital heart disease (CHD). We also evaluated if QoL correlates to age, body mass index (BMI), BNP, and activity level in this population.

Methods: The Pediatric QoL (Peds QoL) Inventory Generic Core Scales and Cardiac Module were administered to 15 children that previously underwent HTx.  Patients wore a pedometer and an accelerometer for 7 days to assess daily activity.  The Peds QoL scores reported by children post-heart transplant were compared with previously published outcomes from children with varying degrees of congenital heart disease published by Uzark et al, 2008.

Results: Age at assessment was 13.1±1.9 years.  Patients were 7.1±5.7 years post-HTx.  BMI was 23.7 ± 9.5 (61±30th percentile).  Daily steps were 8078±2232.  HTx patients spent 13.1±2.0 hrs/day in sedentary activity, 2.3±0.84 hrs/waking day in light activity, 0.58±0.19 hrs/day in moderate intensity activity and 0.74±2.17 hrs/day in vigorous activity.  

There was negative correlation between age at 1st HTx and rating of feelings (-0.638; p=0.01), age at 1st HTx and problems in school (-0.572; p=0.03) and a negative correlation between the patient’s age and their perceived physical appearance (-0.534; p=0.05).  There was a negative correlation between patient’s daily steps and cognitive scores (-0.576; p=0.05), daily steps and health/activities (-0.631; p=0.02), daily steps and feelings (-0.617; p=0.02) and daily steps and school performance (-0.660; p=0.01).  There were no significant correlations between QoL and BMI or BNP.

The HTx group reported similar overall quality of life, physical health, psychosocial health, perceived physical appearance, treatment anxiety, cognitive problems and communication as those previously reported with complex/severe CHD and surgically treated CHD.  The HTx group reported better scores for their treatment and symptoms than those with complex/severe (p<0.001), surgically treated (p<0.001) and moderate CHD (p=0.02).  HTx patients reported lower physical health scores than those with moderate CHD (p<0.01).

Conclusion: Pediatric HTx patients reported similar QoL as patients with complex/severe and surgically treated CHD. HTx patients report minimal problems with treatment and symptoms, but lower physical health compared to CHD populations.  Patients receiving HTx at an older age may require additional emotional and educational support compared to those transplanted at a younger age.  HTx patients with higher baseline activity levels may be more aware of their physical, emotional and cognitive limitations than less active HTx patients.