Pediatric Transplantation. 2018;22:e13110. wileyonlinelibrary.com/journal/petr | 1 of 7 https://doi.org/10.1111/petr.13110 © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd 1 | INTRODUCTION As a result of continued research and advancements in clinical prac- tice, 5-year survival rates for pediatric heart transplant recipients are approaching or exceeding 80%, depending on age at transplant. 1 Given that the purpose of transplantation is not only to extend life but also to enhance the quality of life among this population, 2 attention to outcomes other than survival is needed. With increasing longev- ity of pediatric heart transplant recipients, it is important to evaluate the emotional, behavioral, and social functioning of these patients and their families throughout their post-transplant life. Furthermore, un- derscoring its importance, recipient and parent psychosocial function- ing is associated with health-related outcomes in pediatric solid organ transplant populations, including adherence to the immunosuppres- sant regimen 3,4 and number of hospitalizations. 5 Results of limited studies have suggested that while the majority of pediatric heart transplant recipients report normative psycholog- ical health, a subset of recipients are at increased risk for long-term sequelae. Approximately 30% of pediatric heart transplant recipients have been found to have clinically significant mental health problems Accepted: 7 December 2017 DOI: 10.1111/petr.13110 ORIGINAL ARTICLE Psychosocial functioning in pediatric heart transplant recipients and their families Melissa K. Cousino 1,2 | Kurt R. Schumacher 1,2 | Kelly E. Rea 1 | Sally Eder 1 | Mary Zamberlan 3 | Jessica Jordan 1 | Emily M. Fredericks 1,2,4 Abbreviations: PAT, Psychosocial Assessment Tool; PPPHM, Pediatric Psychosocial Preventative Health Model; SD, standard deviations. 1 Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA 2 University of Michigan Transplant Center, Ann Arbor, MI, USA 3 Department of Cardiac Surgery, Michigan Medicine, Ann Arbor, MI, USA 4 Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI, USA Correspondence Melissa K. Cousino, Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, USA. Email: melcousi@med.umich.edu Funding information University of Michigan Transplant Center Abstract Across pediatric organ transplant populations, patient and family psychosocial func- tioning is associated with important health-related outcomes. Research has suggested that pediatric heart transplant recipients and their families are at increased risk for adverse psychosocial outcomes; however, recent investigation of psychosocial func- tioning in this population is lacking. This study aimed to provide a contemporary char- acterization of psychosocial functioning in pediatric heart transplant recipients and their families. Associations between psychosocial function, demographic variables, and transplant-related variables were investigated. Fifty-six parents/guardians of pediatric heart transplant recipients completed a comprehensive psychosocial screen- ing measure during transplant follow-up clinic visits. Descriptive statistics, correla- tional analyses, and independent samples t tests were performed. Forty percent of pediatric heart transplant recipients and their families endorsed clinically meaningful levels of total psychosocial risk. One-third of patients presented with clinically signifi- cant psychological problems per parent report. Psychosocial risk was unassociated with demographic or transplant-related factors. Despite notable improvements in the survival of pediatric heart transplant recipients over the past decade, patients and families present with sustained psychosocial risks well beyond the immediate post- transplant period, necessitating mental health intervention to mitigate adverse impact on health-related outcomes. KEYWORDS heart transplant, pediatric transplant, psychosocial functioning, psychosocial screening