Factors Associated with Transplant-Specific Psychological Adaptation Among Heart and Kidney Transplant Recipients

Background: Psychological adaptation after solid organ transplantation extends beyond graft survival and includes transplant-specific emotional responses that may influence long-term health outcomes. However, factors associated with transplant-specific psychological adaptation remain insufficiently understood, particularly in Central European populations. Methods: A multicentre cross-sectional study was conducted among 224 adult heart (n = 107) and kidney (n = 117) transplant recipients attending three Polish transplant centers. Participants completed the Transplant Effects Questionnaire (TxEQ), Hospital Anxiety and Depression Scale (HADS), General Self-Efficacy Scale (GSES), Life Orientation Test-Revised (LOT-R), and SF-36. We performed univariable and multivariable linear regression analyses separately for heart and kidney transplant recipients to identify factors associated with transplant-specific psychological adaptation. Results: Overall psychological adaptation was favorable. Adherence demonstrated the highest TxEQ scores, whereas donor-related guilt and disclosure concerns were relatively low. Approximately 20.53% of participants reported clinically relevant anxiety symptoms and 14.2% reported depressive symptoms. In heart transplant recipients, better mental health-related quality of life was independently associated with greater adherence (β = 0.025, p = 0.003). Among kidney transplant recipients, higher donor-related guilt was associated with transplantation center, while greater disclosure was associated with male sex, transplantation center, and shorter time since transplantation (all p < 0.05). Several psychological variables were associated with selected domains of transplant-specific psychological adaptation, whereas demographic and clinical variables showed fewer significant associations. Conclusions: These findings indicate that several psychological variables were associated with transplant-specific psychological adaptation in long-term heart and kidney transplant recipients. Routine assessment of anxiety, mental health-related quality of life, and transplant-specific emotional responses may facilitate identification of recipients who could benefit from further psychosocial evaluation. Prospective studies are needed to determine whether these associations translate into improved long-term outcomes.