Return to Work After Heart Transplantation: Discrepancy with Subjective Work Ability

Background: This study evaluates the objective rate of return to work after heart transplantation (HTX) in comparison with the patients' subjective rating of their work ability and identifies predictors for return to work in a German heart transplant center.

Methods: A questionnaire covering demographics, clinical data, and professional aspects was sent to 200 heart transplant recipients at least 12 months after HTX. Participation was strictly anonymous enabling reliable results concerning subjective work ability.

Results: Response rate was 150 of 200 (75%). During the time after HTX, 45 of 150 (30.0%) patients had ever been in a job. Thirty-five of 95 (36.8%) patients of formal working age (<65 years) were employed after 12.6+/-1.9 months: 18 of 95 (18.9%) in full-time work, 9 of 95 (9.5%) in part-time work, and 6 of 95 (6.3%) in casual employment. Two of 95 (2.1%) patients worked as handicapped employees; only 1 of 95 (1.1%) patients was currently seeking work. Patients obtained financial benefits from their illness (n=54; 36%) or age-related annuity (n=8; 5.3%). Forty-two of 95 (44.2%) patients did not feel capable of working, three patients did not answer, and 50 of 95 patients (52.6%) felt fit for employment. Employment after HTX depended on age, duration of unemployment, diabetes mellitus, and financial need for paid employment. Financially independent patients (n=66) more often felt unable to work by subjective judgement (n=34/67; 50.7%) than patients who depended on paid employment (8/28; 28.6%; P<0.05).

Conclusions: The rate of employment after HTX in Germany is significantly lower than the subjective perception of the individual ability to work; underscoring the importance of sociodemographic and psychologic aspects during rehabilitation of HTX recipients.