An Eight-Year Followup Study after Heart Transplantation: The Relevance of Psychosocial and Psychiatric Background

Round 1

Reviewer 1 Report

I congratulate authors for their effort to analyze  psychosocial and psychiatric features associated with a long-term follow up after a HT. And secondly, to assess the cognitive status and quality of life eight years after the transplant to describe and differentiate  neuroticism and openness to experience and positive reinterpretation in adults.

The weakness is a retrospective extension of prior study (Ref:4: Amigo, I. Manual de psicología de la salud. 4th edition. Pirámide: Madrid. 2020). As this is in spanish, I could not access. Also, the Reference pages are missing. I recommend authors to describe the study in Methods section rather than referring to this paper.

Rest of the results and discussions are appropriate.

From this study, did authors implement any intervention to improve the quality of life in their program.

What is authors recommendation in general for transplant community in future to improve the quality of life in adults after heart transplant.

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

In this paper, authors studied and compared the differences in personality, coping mechanisms, locus of control, clinical and epidemiological information of the participants that had a heart transplant and have ended the follow-up vs  those who haven’t. They found that higher age and the presence of current or historical psychiatric diagnoses was significant in the group who did not finish the follow-up.  

Some concerns:

• the aim of the paper has to be elucidated in the abstract and at the end of the Introduction;
• authors didn't focus on patients transplanted for systemic disorders, where the psychological aspects are more important being affected by a systemic and multi-organ disease, where the transplantation of the single heart doesn't relieve the entire disease. For this purpose, I suggest to spend some words in the Discussion, looking at some examples: "Heart Transplantation in Kearns-Sayre Syndrome. Transplantation. 2019 Dec;103(12):e393-e394. doi: 10.1097/TP.0000000000002860. PMID: 31335783" and "Di Nora C, Livi U. Heart transplantation in cardiac storage diseases: data on Fabry disease and cardiac amyloidosis. Curr Opin Organ Transplant. 2020 Jun;25(3):211-217. doi: 10.1097/MOT.0000000000000756. PMID: 32304420".
• why did 20 out of 125 patients refuse the study? Please explain that.
• why did the authors tranplant patients with known pre-transplant psychiatric disorders?

Thank you for your next comments on these concerns.

Author Response

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Author Response File: Author Response.pdf

Reviewer 3 Report

The paper is poor written.

I suggest extensive language and grammatical revision, after this the reviewer can reevaluate the content of the paper.

1) The design research is not adequately described. The authors state " This is a quasi-experimental-designed research based on the previous study [4]. ",however reference 4 is a textbook ( Amigo, I. Manual de psicología de la salud. 4th edition. Pirámide: Madrid. 2020) 2) Inclusion and exclusion criteria are not clear. Why the upper limit of age is 75 years (heart transplant can be performed only in patients with age < 65-70 years). How was be excluded mental retardation or cognitive impairment before HT?
3)In which period authors enrolled the patients (one year, ten years) please specify. 4) The authors state " The research met the ethical criteria from the Hospital Committee and the International Society for Heart and Lung Transplantation. What are the ethical criteria of ISHLT? 
5) language is very poor and is very difficult to comprehend the meaning of the paper
6) Carefully revision of References is required, in the text appears a reference [19] that is not indicated in the references list.
 

 

 

Author Response

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Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

The authors have addressed all my previous concerns and the paper results now suitable for publication.

Author Response

Thank you one more time, for you effort and patience

Reviewer 3 Report

The authors addressed the majority of my comments

However, I still recommend professional English editing prior to the publication of the manuscript 

Author Response

Dear editor,

The manuscript underwent an English editing twice. I hope these corrections may help to reach your English standards.

Thank you one more time for your time and patience