The importance of mental toughness on lung transplant outcomes is unknown. We performed a pilot study to assess whether pretransplant grit and resilience are associated with short-term posttransplant outcomes. We enrolled 31 lung transplant candidates, of whom 7 (26%) had greater mental toughness, defined as the upper tertile for both grit and resilience within our cohort. There were no differences in baseline characteristics between patients with higher and lower mental toughness. Greater mental toughness was associated with a shorter hospital length of stay (LOS) [12 days (interquartile range, IQR 10-12) vs. 17 days (IQR 14-24), p = 0.02] and reduced posttraumatic stress severity [median 0 (IQR 0-2) vs. 6.5 (IQR 4-9), p < 0.01]. On multivariable analyses adjusting for age and Duke Activity Status Index, greater mental toughness was associated with a shorter hospital LOS [beta = -11.96 (95% CI 0.05-23.86), p < 0.05] and reduced PTSD [beta = -10.7 (95% CI -21.6-0.04), p = 0.053]. Lung transplant candidates with greater mental toughness may have improved short-term outcomes.
Keywords: Grit; PTSD; lung transplant; mental toughness; outcomes; resilience.
© 2025 The Author(s). Clinical Transplantation published by John Wiley & Sons Ltd.