Mental disorders and liver transplantation: a 2-year cohort study

Afiliação

(1)    Universidade Federal da Bahia, Programa de Pós-Graduação em Medicina e Saúde, Salvador, BA, Brasil.

(2)    Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Serviço de Hepatologia, Salvador, BA, Brasil.

(3)    Universidade Federal de São Paulo, Departamento de Psiquiatria, Pós-graduação de Psiquiatria e Psicologia Médica, São Paulo, SP, Brasil.

(4)    Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria de Salvador, Salvador, BA, Brasil.

Resumo

Background: Psychosocial assessment is a key component in evaluation for liver transplantation and may affect survival rates and outcomes. Objective: The primary aim of this study was to investigate the impact of previous mental disorders and impulsivity on the 2-year surviving rate after liver transplantation. Methods: We performed a prospective cohort study assessing end-stage liver disease individuals with and without psychiatric comorbidities for 2 years post-transplant. Psychiatric diagnosis was carried out through Mini-Plus 5.0.0 and impulsivity by using Barratt Impulsiveness Scale in the pre-transplant phase. We followed patient's status for 2 years after transplantation. The main outcome was death. We used a logistic regression to evaluate the association of psychiatric comorbidities with death and performed a survival analysis with Kaplan-Meier and Cox regression models. Results: Between June 2010 and July 2014, 93 out of 191 transplant candidates received transplants. From the 93 transplant patients, 21 had psychiatric comorbidities and 72 had not. 25 patients died during the study. The presence of psychiatric comorbidities (P=0.353) and high impulsivity (P=0.272) were not associated to 2-year post transplant death. Conclusion: This study found no evidence that the presence of mental disorders and impulsivity worsened prognosis in post-liver transplantation.