@Article{chd.12513,
AUTHOR = {Dmitry Tumin, Helen Chou, Don Hayes Jr,3,4, Joseph D. Tobias,5, Mark Galantowicz, Patrick I. McConnell},
TITLE = {Employment after heart transplantation among adults with congenital heart disease},
JOURNAL = {Congenital Heart Disease},
VOLUME = {12},
YEAR = {2017},
NUMBER = {6},
PAGES = {794--799},
URL = {http://www.techscience.com/chd/v12n6/39222},
ISSN = {1747-0803},
ABSTRACT = {Objective: Adults with congenital heart disease may require heart transplantation for end-stage
heart failure. Whereas heart transplantation potentially allows adults with congenital heart disease
to resume their usual activities, employment outcomes in this population are unknown. Therefore,
we investigated the prevalence and predictors of work participation after heart transplantation for
congenital heart disease.
Design: Retrospective review of a prospective registry.
Setting: United Network for Organ Sharing registry of transplant recipients in the United States.
Patients: Adult recipients of first-time heart transplantation with a primary diagnosis of congenital
heart disease, performed between 2004 and 2015.
Interventions: None.
Outcome measures: Employment status reported by transplant centers at required follow-up
intervals up to 5 y posttransplant.
Results: Among 470 patients included in the analysis (mean follow-up: 5 ± 3 y), 127 (27%)
worked after transplant, 69 (15%) died before beginning or returning to work, and 274 (58%) survived until censoring, but did not participate in paid work. Multivariable competing-risks
regression analysis examined characteristics associated with posttransplant employment, accounting for mortality as a competing outcome. In descriptive and multivariable analysis, pretransplant
work participation was associated with a greater likelihood of posttransplant employment, while
the use of Medicaid insurance at the time of transplant was associated with a significantly lower
likelihood of working after transplant (subhazard ratio compared to private insurance: 0.55; 95%
confidence interval: 0.32, 0.95; P = .032).
Conclusions: Employment was rare after heart transplantation for congenital heart disease, and
was significantly less common than in the broader population of adults with congenital heart disease. Differences in return to work were primarily related to pretransplant employment and the
use of public insurance, rather than clinical characteristics.},
DOI = {10.1111/chd.12513}
}