9 LONGITUDINAL ASSESSMENT OF PSYCHOLOGICAL FUNCTIONING AFTER PAEDIATRIC HEART OR HEART-LUNG TRANSPLANTATION J.O. Wray, 1 R. Radley-Smith, 11 Department of Cardiothoracic Transplantation, Royal Brompton and Harefield NHS Trust, Harefield, Middlesex, United Kingdom Background: Despite the increasing numbers of paediatric heart and lung transplants being performed worldwide, longitudinal psycholog- ical evaluation of children and adolescents undergoing transplanta- tion remains uncommon. Method: Thirty-four children and adolescents were evaluated at 12 months and 3 years after heart (n=24) or heart-lung (n=10) trans- plantation for congenital heart disease (CHD) (n=10), cardiomyopa- thy (CM) (n=21), cystic fibrosis (n=1) or primary pulmonary hyper- tension (n=2). There were 18 boys and 16 girls and the mean age at the 12 month assessment was 7.9 years (range: 1.3–15.3 years). Standardised measures were used to assess development, cognitive function, mood state and behaviour at home and at school at each test occasion. Results: Measures of developmental, cognitive and academic func- tion were within the normal range at each occasion. The prevalence of behaviour problems at home and at school was 29% and 26% respectively at 12 months and 30% and 21% at 3 years, which is higher than the 10% reported for the normal population. The prevalence of depression fell from 25% at 12 months to 10% at 3 years. Whilst there were no significant differences between heart and heart-lung recipi- ents, children with a pre-transplant diagnosis of CHD obtained poorer scores on cognitive and behavioural parameters than those with CM. In particular, whilst the prevalence of behaviour problems at home decreased over time from 20% to 11% in the CM group, it increased from 38% at 12 months to 63% at 3 years in the CHD group. Conclusion: A number of paediatric patients continue to have psychological difficulties 3 years after transplant. Initial diagnosis is an important factor in post-transplant psychological functioning, with a diagnosis of CHD appearing to be a risk factor for greater psycholog- ical morbidity, at least in the short and medium term. Further follow-up needs to address whether such differences persist in the longer term and facilitate identification of patients at risk for poorer psychological outcome. 10 HEALTH-RELATED QUALITY OF LIFE IN 280 TRANSPLANT RECIPIENTS C. Kugler, 1 S. Fischer, 1 J. Gottlieb, 2 A. Simon, 1 T. Welte, 2 A. Haverich, 1 M. Strueber, 11 Hannover Thoracic Transplant Program, Hannover Medical School, Hannover, Germany; 2 Division of Respiratory Medicine, Hannover Medical School, Hannover, Germany Health-related quality of life (HRQoL) has increasingly been accepted as a supplementary outcome measure for patients after lung trans- plantation (LTx). Previous studies report on overall improvements in HRQoL after LTx, although the results are often limited by small sample sizes. The purpose of this study was to determine the impact of LTx on patients’ perceptions of HRQoL within a larger cohort and to compare these data with a normative sample. Using a retrospective cross-sectional study design, 280 LTx recipients (3 months to 14 years) were asked to assess their perceived HRQoL using a generic (Quality of Life Profile for Chronic Diseases) questionnaire, which was previously validated for this specific population. This question- naire was also performed by 155 healthy participants. All subscales ranged between 2.02 to 3.34 (0 –5) for all patients following LTx. A significant decrease of the perceived HRQoL was associated with the incidence of the bronchiolitis obliterans syndrome (BOS, p0.046). Cystic Fibrosis patients (p.015), single lung transplant recipients (p.047), and patients at higher age (p.015) showed decreased physical ability ratings. Patients who remained free of infections and free of late acute rejection episodes scored themselves significantly higher regarding their relaxation capabilities (p.047 rej.; p.018 inf.) and their “social functioning” (p.005 rej.; p.014 inf.). Com- parisons with a normative cohort showed similar HRQoL scales for LTx patients and the healthy population, explicit the scale “social functioning” (p.004). The perceived HRQoL by the individual significantly improves after LTx for all dimensions, and remains relatively constant. HRQoL is dependent from the incidence of infections, rejections, and BOS. Despite differences in regards to the life expectancy of LTx patients versus the healthy population, self- ratings regarding HRQoL are within the same ranges. This necessitates further efforts to intensify research within this patient population. 11 PREDICTORS OF NEGATIVE AFFECT AT 5– 6 YEARS AFTER HEART TRANSPLANTATION K.L. Grady, 1 B. Rybarczyk, 2 D.C. Naftel, 3 J.K. Kirklin, 3 C. White-Williams, 3 J. Kobashigawa, 4 J. Chait, 4 J.B. Young, 5 D. Pelegrin, 5 J. Czerr, 5 R. Higgins, 1 M. McLeod, 1 J. Rissinger, 1 A. Heroux, 11 Cardiology, Rush University Medical Center, Chicago, IL; 2 Cardiothoracic Surgery, University of Alabama, Birmingham, AL; 3 Cardiology, University of California, Los Angeles, CA; 4 Cardiology, Cleveland Clinic Foundation, Cleveland, OH Few studies have examined predictors of negative affect in patients (pts) long term after heart transplantation (HT). The purposes of this study were to (1) describe the frequency of negative affect, identify differences in negative affect by demographic variables, and identify predictors of negative affect in pts at 5 - 6 years after HT. Methods: Prospective data were collected from a nonrandom sample of pts at four U. S. medical centers using these instruments: Positive and Negative Affect Schedule - Expanded version (PANAS-X), Cardiac Depression Scale (CDS) (items measuring uncertainty and sleep), Sickness Impact Profile, HT Symptom Checklist, Social Support Index, and chart review. Statistical analyses included frequencies, means, chi-square, independent t-tests, and multiple regression. Level of significance was set at 0.05 for all analyses. Results: Pts.(n=300) were 78% male, 90% white, and mean age = 59  10 years. Using the PANAS-X, 20% of pts scored in the clinically significant range based on norms. Women and older pts reported more negative affect versus men and younger pts. Using stepwise multiple regression, more uncertainty, more disability in recreational activities, and neurological and gastrointestinal symptoms predicted more negative affect, explaining 42% of variance (p0.0001). Conclusion: These results suggest that perceived uncertainty, func- tional disability, and symptoms are strongly related to emotional adjustment among long-term HT pts. These findings can help identify pts who may be at risk for poor adjustment and compromised clinical outcomes many years after HT. 12 PROFILES AND PREDICTORS OF PSYCHIATRIC DISTRESS ACROSS 4 YEARS AFTER HEART TRANSPLANTATION M.A. Dew, 1 L. Myaskovsky, 1 A.F. DiMartini, 1 G.E. Switzer, 2 R.L. Kormos, 31 Psychiatry, University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, PA; 2 Medicine, University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, PA; 3 Surgery, University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, PA The Journal of Heart and Lung Transplantation Abstracts S45 Volume 24, Number 2S