Quality of Life After Heart Transplantation: Instruments, Domains, and Variations by Time, Age, and Gender

Quality of life (QoL) has become a central outcome in heart transplantation, complementing traditional metrics of graft survival and clinical morbidity. As advances in surgical technique and immunosuppression have extended posttransplant longevity, understanding how patients function and experience daily life has gained increasing clinical relevance. The objective of this review is to synthesize contemporary evidence on QoL across the physical, psychological, social, and treatment-related domains, with particular emphasis on how these dimensions evolve over early, intermediate, and long-term follow-up. We summarize established tools for assessing QoL, highlight key determinants in each domain, and describe how factors such as exercise capacity, emotional recovery, social reintegration, and immunosuppressive burden contribute to the patient experience over time. Special attention is given to the limited but growing data on long-term survivors, whose QoL trajectories reveal both sustained benefits and emerging challenges decades after transplantation. Together, this review provides a comprehensive overview of current knowledge and outlines what clinicians and researchers can expect when evaluating QoL in heart transplant recipients.