Pre-liver transplant psychosocial evaluation predicts post-transplantation outcomes

Psychol Health Med. 2018 Aug;23(7):788-796. doi: 10.1080/13548506.2017.1417610. Epub 2017 Dec 26.

Abstract

Psychosocial factors greatly impact the course of patients throughout the liver transplantation process. A retrospective chart review was performed of patients who underwent liver transplantation at Hadassah-Hebrew University Medical Center between 2002 and 2012. A composite psychosocial score was computed based on the patient's pre-transplant evaluation. Patients were divided into two groups based on compliance, support and insight: Optimal psychosocial score and Non-optimal psychosocial score. Post-liver transplantation survival and complication rates were evaluated. Out of 100 patients who underwent liver transplantation at the Hadassah-Hebrew University Medical Center between 2002 and 2012, 93% had a complete pre-liver transplant psychosocial evaluation in the medical record performed by professional psychologists and social workers. Post-liver transplantation survival was significantly higher in the Optimal group (85%) as compared to the Non-optimal group (56%, p = .002). Post-liver transplantation rate of renal failure was significantly lower in the Optimal group. No significant differences were observed between the groups in other post-transplant complications. A patient's psychosocial status may impact outcomes following transplantation as inferior psychosocial grades were associated with lower overall survival and increased rates of complications. Pre-liver transplant psychosocial evaluations are an important tool to help predict survival following transplantation.

Keywords: Liver transplant; post-transplantation outcomes; psychosocial evaluation.

MeSH terms

  • Adult
  • Female
  • Humans
  • Liver Transplantation / psychology*
  • Male
  • Middle Aged
  • Patient Compliance*
  • Postoperative Complications / epidemiology*
  • Preoperative Care
  • Renal Insufficiency / epidemiology*
  • Retrospective Studies
  • Social Support*
  • Survival Rate*
  • Treatment Outcome