Association of parental pretransplant psychosocial assessment with post-transplant morbidity in pediatric heart transplant recipients

Because parents assume the primary responsibility for pro- viding ambulatory post-transplant care to pediatric patients, pretrans- plant psychosocial evaluation in these recipients is usually focused on parents rather than on patients themselves. We sought to determine whether pretransplant parental psychosocial evaluation predicts post- transplant medical outcome at current levels of psychosocial support. We compared relative risk (RR) of rejection and hospitalizations (days of all-cause hospitalization) following initial discharge in patients in risk and control groups defined by their pretransplant parental psy- chosocial evaluation. We also compared the two groups of patients for the proportion of all outpatient trough cyclosporine A (CSA) or tac- rolimus (FK) levels that were