Transplant Psychiatry

Journal Article Annotations
2021, 2nd Quarter


Annotations by Sarah R. Andrews, MD
April, 2021

  1. Marijuana use among adult liver transplant candidates and recipients.
  2. Quality of Life and Mental Health in Kidney Transplant Recipients During the COVID-19 Pandemic.

    PUBLICATION #1 — Suicide

    Marijuana use among adult liver transplant candidates and recipients.
    Alisa Likhitsup, Naba Saeed, Gerald Scott Winder, Ammar Hassan, Christopher J Sonnenday, Robert J Fontana


    The finding:
    This large retrospective study evaluated liver transplant candidates and their self-reported marijuana (MJ) use history. Nearly one-quarter of liver transplant candidates reported a history of MJ use, and 11% reported use in the last year. The probability of listing for transplant decreased among MJ users with longer time to listing compared to non-users. Among the transplanted patients, survival post-transplant was similar in both MJ users and non-users.

    Strength and weaknesses:
    This study has several strengths, including analysis of a large sample size for liver transplant candidates, even though it was only a single-site study. The limitations of the study include that MJ use was self-reported and collected from medical records. MJ use was difficult to quantify.

    Given the controversial issue whether or not MJ use should be a contraindication for solid organ transplantation, this study is useful for C-L psychiatrists evaluating liver transplant patients in order to help determine the significance and relevance of marijuana use in transplant: there were no significant differences with post-transplant survival depending on marijuana use. Further studies should continue to address MJ in the transplant population.

    Type of study (EBM guide):
    Retrospective study

    PUBLICATION #2 — Suicide

    Quality of Life and Mental Health in Kidney Transplant Recipients During the COVID-19 Pandemic.
    Concetta De Pasquale, Maria Luisa Pistorio, Pierfrancesco Veroux, Rossella Gioco, Alessia Giaquinta, Francesca Privitera, Massimiliano Veroux


    The finding:
    This study evaluated 89 kidney transplant recipients in the setting of the COVID-19 pandemic. The Middle Hospital Questionnaire (MHQ) was used to evaluate anxiety, depression, somatic concerns, and insomnia as well as the SF-36 Health Survey regarding physical and emotional health. Over one-quarter of recipients reported changes in their emotional state. Sixteen percent reported difficulties in sleep. There was no demonstrated significant impact on socialization. Fifty percent of patients reported changes in their emotional state due to the pandemic. Despite the stressors of the pandemic, there was no significantly observed impact on the overall functioning of this transplant patient population when compared to a preceding time period.

    Strength and weaknesses:
    The strength of this study was that this cohort of transplant patients had recorded data prior to and during the pandemic, which allowed for longitudinal comparison. Additional time points should be further analyzed to determine if the ongoing length and severity of the pandemic worsens or improves psychosocial outcomes. One weakness includes that interaction between variables were not controlled in the study given the type of study. Sample size calculations were also not included in the study, which could have impacted the results.

    As C-L psychiatrists have been managing patients during the pandemic, this study is vital to understanding the impact of the pandemic on transplant patients, which does not appear to be consistent with the general population. It will be important to continue to study the impact of the pandemic on the psychological health of kidney transplant patients.


    Type of study (EBM guide): Observational and cross-sectional study