Journal Article Annotations
2018, 1st Quarter
Annotations by Paula Zimbrean, MD, FACLP
Also of interest:
This consensus statement was initiated by the Transplant Medicine special interest group (chair Prof. Frank Vinitius) of the European Association of Psychosomatic Medicine. Several members of ACLP’s Transplant Psychiatry special interest group also participated. This article outlines what experts considered to be the most important components of the psychosocial assessment of altruistic kidney donor candidates. The publication also includes recommendations about optimal logistic issues such as timing of the evaluation and use of collateral resources in communication with the primary medical team.
Type of study: Prospective cohort study
The finding: This is the long-term follow-up on a similar study the authors reported in 2010. At the time, depression and social isolation pretransplant was associated with higher mortality 1 year after heart transplantation. The current study indicates that the association was maintained up to 8 years after heart transplantation: low depression at the time of wait-listing and good social integration was associated with increased chances of survival after heart transplantation.
Strength and weaknesses: The main strength of this study consists in the prospective design and long-term follow-up (medial follow up 70 months). The study also controlled for many demographic and clinical factors that are involved in posttransplant survival. Limitations of the study are due to the fact that the assessment for depression and social isolation were self-reported, therefore subjective, and also there was no assessment nor analysis of potential psychosocial confounding factors that may be associated with depression.
Relevance: The study supports the association between symptoms and social isolation prior to transplantation and increased mortality of the heart transplant.
Type of study: Systematic review of literature
The finding: In liver transplant recipients, the rate of employment after transplantation is lower than pretransplantation.
Strength and weaknesses: This is a systematic review of publications between 2001 and 2016 as they appeared in two databases: Pubmed and Embase. The main limitation of the study is due to the heterogeneous character of the data in individual publications which did not allow meta-analysis.
Relevance: With survival posttransplantation increasing, the focus is shifting from medical outcomes, such as mortality and graft loss, to quality of life and social re-integration. This study lays the groundwork to further understand and address the factors contributing to lower employment rates after transplant surgery.