HPRHealth Psychology ResearchTBA2420-8124Health Psychology Research10.4081/hpr.2014.1549GeneralPost-traumatic stress  symptoms in pediatric  heart transplant recipientshttps://healthpr.org/journal/HPR/2/2/10.4081/hpr.2014.1549E. EvanElana,A. PatelPayal,AmegatcherAlison,HalnonNancy2014222014-04-26Traumatic experiences are not unusual in pediatric heart transplant (HT) recipients before and after transplantation. Post-traumat ic stress symptoms (PTSS) present at the time of transplant evaluation and developing after ward occur with an unknown frequency. We sought to determine the burden of these symp toms in heart transplant patients. We reviewed 51 consecutive HTs between 2003-2007, including 40 primary transplants and 11 re transplants. Symptoms were present in 17 of the 51 patients (34%) at the time of orthotopic heart transplantation evaluation. None met the criteria for full post traumatic stress disor der. Transplant complications were examined. Nineteen subjects of the total sample had rejection in the first year following transplant. Rejection rates in the first year was 41% for those with PTSS (7 of 17 patients) and 36% for those without (12 of 33 patients) (P=n.s). Of those patients presenting for a second heart transplant, 55% had PTSS at the time of trans plant evaluation and/or the peritransplant peri od; whereas, (28%) undergoing a primary transplant had PTSS. In addition to symptoms resulting from the disease process leading to HT and other prior experiences, the HT itself seems to present a large psychiatric burden on patients. All patients need to be followed before and after HT for signs and symptoms related to PTSS. Future studies should be undertaken to determine if preventative detec tion and treatment of patients with these PTSS symptoms early can lead to better outcomes.posttraumatic stress symptoms, pedi atric heart transplant, rejection

1. Todaro JF, Fennell EB, Sears SF. Review: cognitive and psychological outcomes in pediatric heart transplantation. J Pediatr Psychol 2000;25:567-76.2. Mintzer LL, Stuber ML, Seacord D, et al. Traumatic stress symptoms in adolescent organ transplant recipients. Pediatrics 2005;115:1640-4.3. Stuber ML, Shemesh E. Posttraumatic stress disorder in medically ill patients: what is known, what needs to be determined, and why is it important? CNS Spectr 2006;11;106-12.4. Kazak AE, Alderfer MA, Streisand R, et al. Treatment of posttraumatic stress symptoms in adolescent survivors of childhood cancer and their families: a randomized clinical trial. J Fam Psychol 2004;18:493-504. 5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 2000.6. Cavalcanti-Ribeiro P, Andrade-Nascimento M, Morais-de-Jesus M, et al. Post-traumatic stress disorder as a comorbidity: Impact on disease outcomes. Expert Rev Neurother 2012;12:1023-37.7. Bunzel B, Laederach-Hoffman K. Solid organ transplantation: are there predictors for posttransplant noncompliance? Transplantation 2000;70:711-6.8. Chartrand C, Servando ES, Chartrand S. Risk factors for acute rejection alter pediatric heart transplantation. Transplant Proc 2001;33:1732-4.9. Steinberg AM, Brymer MJ, Kim S, et al. Psychometric properties of the UCLA PTSD reaction index: part I. J Trauma Stress 2013;26:1-9.