The Stanford Integrated Psychosocial Assessment for Transplant is Associated with Outcomes Before and After Liver Transplantation.
Identifieur interne : 000216 ( Main/Exploration ); précédent : 000215; suivant : 000217The Stanford Integrated Psychosocial Assessment for Transplant is Associated with Outcomes Before and After Liver Transplantation.
Auteurs : Sasha Deutsch-Link [États-Unis] ; Ethan M. Weinberg [États-Unis] ; Therese Bitterman [États-Unis] ; Mackenzie Mcdougal [États-Unis] ; Aniket Dhariwal [États-Unis] ; Lauren S. Jones [États-Unis] ; Robert M. Weinrieb [États-Unis] ; Arpita G. Banerjee [États-Unis] ; Senayish Addis [États-Unis] ; Marina Serper [États-Unis]Source :
- Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society [ 1527-6473 ] ; 2020.
Abstract
BACKGROUND
The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) is a standardized psychosocial evaluation tool used in liver transplant (LT) evaluation. Study aims were to assess the impact of the SIPAT score and sub-score domains on transplant waitlisting decisions and post-LT outcomes including immunosuppression (IS) non-adherence, biopsy-proven rejection, and mortality/graft failure.
METHODS
We conducted a single center observational cohort study of 1430 patients evaluated for LT. Patients were divided in two groups based on a SIPAT cutoff of score < or ≥ 21 (higher SIPAT scores indicate higher psychosocial risk). Tacrolimus coefficient of variation (CoV) was used to measure IS non-adherence. Regression models assessed the relationship between total SIPAT score and domain scores and waitlisting decisions, IS non-adherence, allograft rejection, and patient death/graft failure.
RESULTS
Patients with elevated total SIPAT and SIPAT domain scores were at higher risk of not being waitlisted for LT (total SIPAT ≥21 aOR=1.78, CI 1.36-2.33, readiness ≥5 aOR=2.01, CI 1.36-2.76, social support ≥4 aOR=1.50, CI 1.15-1.94, psychopathology ≥7 aOR=1.45, CI 1.07-1.94, and lifestyle/substance abuse ≥12 aOR=1.72, CI 1.23-2.39), and were more likely to experience IS non-adherence as measured by the tacrolimus CoV (total SIPAT ≥21 aOR=2.92, CI 1.69-5.03, readiness ≥5 aOR=3.26, CI 1.63-6.52, psychopathology ≥7 aOR=1.88, CI 1.00-3.50, and lifestyle substance abuse ≥ 12 aOR=3.03, CI 1.56-5.86). Patients with a SIPAT readiness score ≥5 were more likely to experience biopsy-proven allograft rejection (aOR=2.66, CI 1.20-5.91).
CONCLUSION
The SIPAT score was independently associated with LT listing decisions and IS non-adherence, and the readiness domain was associated with risk of allograft rejection. These findings offer insights into higher risk recipients that may require additional support prior to and after transplantation.
DOI: 10.1002/lt.25975
PubMed: 33320417
Affiliations:
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Weinberg</name><affiliation wicri:level="2"><nlm:affiliation>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Bitterman, Therese" sort="Bitterman, Therese" uniqKey="Bitterman T" first="Therese" last="Bitterman">Therese Bitterman</name><affiliation wicri:level="2"><nlm:affiliation>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Mcdougal, Mackenzie" sort="Mcdougal, Mackenzie" uniqKey="Mcdougal M" first="Mackenzie" last="Mcdougal">Mackenzie Mcdougal</name><affiliation wicri:level="2"><nlm:affiliation>Drexel University College of Medicine, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Drexel University College of Medicine, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Dhariwal, Aniket" sort="Dhariwal, Aniket" uniqKey="Dhariwal A" first="Aniket" last="Dhariwal">Aniket Dhariwal</name><affiliation wicri:level="2"><nlm:affiliation>University of Pennsylvania, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Pennsylvania, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Jones, Lauren S" sort="Jones, Lauren S" uniqKey="Jones L" first="Lauren S" last="Jones">Lauren S. Jones</name><affiliation wicri:level="2"><nlm:affiliation>Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Philadelphia College of Osteopathic Medicine, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Weinrieb, Robert M" sort="Weinrieb, Robert M" uniqKey="Weinrieb R" first="Robert M" last="Weinrieb">Robert M. Weinrieb</name><affiliation wicri:level="2"><nlm:affiliation>Department of Psychiatry, University of Pennsylvania Perelman School of medicine, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, University of Pennsylvania Perelman School of medicine, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Banerjee, Arpita G" sort="Banerjee, Arpita G" uniqKey="Banerjee A" first="Arpita G" last="Banerjee">Arpita G. Banerjee</name><affiliation wicri:level="2"><nlm:affiliation>Department of Psychiatry, University of Pennsylvania Perelman School of medicine, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, University of Pennsylvania Perelman School of medicine, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Addis, Senayish" sort="Addis, Senayish" uniqKey="Addis S" first="Senayish" last="Addis">Senayish Addis</name><affiliation wicri:level="2"><nlm:affiliation>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Serper, Marina" sort="Serper, Marina" uniqKey="Serper M" first="Marina" last="Serper">Marina Serper</name><affiliation wicri:level="2"><nlm:affiliation>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia</wicri:regionArea><placeName><settlement type="city">Philadelphie</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author></analytic><series><title level="j">Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society</title><idno type="eISSN">1527-6473</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) is a standardized psychosocial evaluation tool used in liver transplant (LT) evaluation. Study aims were to assess the impact of the SIPAT score and sub-score domains on transplant waitlisting decisions and post-LT outcomes including immunosuppression (IS) non-adherence, biopsy-proven rejection, and mortality/graft failure.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We conducted a single center observational cohort study of 1430 patients evaluated for LT. Patients were divided in two groups based on a SIPAT cutoff of score < or ≥ 21 (higher SIPAT scores indicate higher psychosocial risk). Tacrolimus coefficient of variation (CoV) was used to measure IS non-adherence. Regression models assessed the relationship between total SIPAT score and domain scores and waitlisting decisions, IS non-adherence, allograft rejection, and patient death/graft failure.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Patients with elevated total SIPAT and SIPAT domain scores were at higher risk of not being waitlisted for LT (total SIPAT ≥21 aOR=1.78, CI 1.36-2.33, readiness ≥5 aOR=2.01, CI 1.36-2.76, social support ≥4 aOR=1.50, CI 1.15-1.94, psychopathology ≥7 aOR=1.45, CI 1.07-1.94, and lifestyle/substance abuse ≥12 aOR=1.72, CI 1.23-2.39), and were more likely to experience IS non-adherence as measured by the tacrolimus CoV (total SIPAT ≥21 aOR=2.92, CI 1.69-5.03, readiness ≥5 aOR=3.26, CI 1.63-6.52, psychopathology ≥7 aOR=1.88, CI 1.00-3.50, and lifestyle substance abuse ≥ 12 aOR=3.03, CI 1.56-5.86). Patients with a SIPAT readiness score ≥5 were more likely to experience biopsy-proven allograft rejection (aOR=2.66, CI 1.20-5.91).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The SIPAT score was independently associated with LT listing decisions and IS non-adherence, and the readiness domain was associated with risk of allograft rejection. These findings offer insights into higher risk recipients that may require additional support prior to and after transplantation.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33320417</PMID><DateRevised><Year>2020</Year><Month>12</Month><Day>15</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1527-6473</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Dec</Month><Day>15</Day></PubDate></JournalIssue><Title>Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society</Title><ISOAbbreviation>Liver Transpl</ISOAbbreviation></Journal><ArticleTitle>The Stanford Integrated Psychosocial Assessment for Transplant is Associated with Outcomes Before and After Liver Transplantation.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1002/lt.25975</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) is a standardized psychosocial evaluation tool used in liver transplant (LT) evaluation. Study aims were to assess the impact of the SIPAT score and sub-score domains on transplant waitlisting decisions and post-LT outcomes including immunosuppression (IS) non-adherence, biopsy-proven rejection, and mortality/graft failure.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We conducted a single center observational cohort study of 1430 patients evaluated for LT. Patients were divided in two groups based on a SIPAT cutoff of score < or ≥ 21 (higher SIPAT scores indicate higher psychosocial risk). Tacrolimus coefficient of variation (CoV) was used to measure IS non-adherence. Regression models assessed the relationship between total SIPAT score and domain scores and waitlisting decisions, IS non-adherence, allograft rejection, and patient death/graft failure.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Patients with elevated total SIPAT and SIPAT domain scores were at higher risk of not being waitlisted for LT (total SIPAT ≥21 aOR=1.78, CI 1.36-2.33, readiness ≥5 aOR=2.01, CI 1.36-2.76, social support ≥4 aOR=1.50, CI 1.15-1.94, psychopathology ≥7 aOR=1.45, CI 1.07-1.94, and lifestyle/substance abuse ≥12 aOR=1.72, CI 1.23-2.39), and were more likely to experience IS non-adherence as measured by the tacrolimus CoV (total SIPAT ≥21 aOR=2.92, CI 1.69-5.03, readiness ≥5 aOR=3.26, CI 1.63-6.52, psychopathology ≥7 aOR=1.88, CI 1.00-3.50, and lifestyle substance abuse ≥ 12 aOR=3.03, CI 1.56-5.86). Patients with a SIPAT readiness score ≥5 were more likely to experience biopsy-proven allograft rejection (aOR=2.66, CI 1.20-5.91).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The SIPAT score was independently associated with LT listing decisions and IS non-adherence, and the readiness domain was associated with risk of allograft rejection. These findings offer insights into higher risk recipients that may require additional support prior to and after transplantation.</AbstractText><CopyrightInformation>This article is protected by copyright. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Deutsch-Link</LastName><ForeName>Sasha</ForeName><Initials>S</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-0923-4300</Identifier><AffiliationInfo><Affiliation>Department of Gastroenterology & Hepatology, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weinberg</LastName><ForeName>Ethan M</ForeName><Initials>EM</Initials><AffiliationInfo><Affiliation>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bitterman</LastName><ForeName>Therese</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McDougal</LastName><ForeName>Mackenzie</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Drexel University College of Medicine, Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dhariwal</LastName><ForeName>Aniket</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>University of Pennsylvania, Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jones</LastName><ForeName>Lauren S</ForeName><Initials>LS</Initials><AffiliationInfo><Affiliation>Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weinrieb</LastName><ForeName>Robert M</ForeName><Initials>RM</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, University of Pennsylvania Perelman School of medicine, Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Banerjee</LastName><ForeName>Arpita G</ForeName><Initials>AG</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, University of Pennsylvania Perelman School of medicine, Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Addis</LastName><ForeName>Senayish</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Serper</LastName><ForeName>Marina</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Division of Gastroenterology & Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>12</Month><Day>15</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Liver Transpl</MedlineTA><NlmUniqueID>100909185</NlmUniqueID><ISSNLinking>1527-6465</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Allograft Rejection</Keyword><Keyword MajorTopicYN="N">SIPAT</Keyword><Keyword MajorTopicYN="N">Tacrolimus Coefficient of Variation</Keyword><Keyword MajorTopicYN="N">Transplant Waitlist</Keyword><Keyword MajorTopicYN="N">non-adherence</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate 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sortKey="Addis, Senayish" sort="Addis, Senayish" uniqKey="Addis S" first="Senayish" last="Addis">Senayish Addis</name><name sortKey="Banerjee, Arpita G" sort="Banerjee, Arpita G" uniqKey="Banerjee A" first="Arpita G" last="Banerjee">Arpita G. Banerjee</name><name sortKey="Bitterman, Therese" sort="Bitterman, Therese" uniqKey="Bitterman T" first="Therese" last="Bitterman">Therese Bitterman</name><name sortKey="Dhariwal, Aniket" sort="Dhariwal, Aniket" uniqKey="Dhariwal A" first="Aniket" last="Dhariwal">Aniket Dhariwal</name><name sortKey="Jones, Lauren S" sort="Jones, Lauren S" uniqKey="Jones L" first="Lauren S" last="Jones">Lauren S. Jones</name><name sortKey="Mcdougal, Mackenzie" sort="Mcdougal, Mackenzie" uniqKey="Mcdougal M" first="Mackenzie" last="Mcdougal">Mackenzie Mcdougal</name><name sortKey="Serper, Marina" sort="Serper, Marina" uniqKey="Serper M" first="Marina" last="Serper">Marina Serper</name><name sortKey="Serper, Marina" sort="Serper, Marina" uniqKey="Serper M" first="Marina" last="Serper">Marina Serper</name><name sortKey="Weinberg, Ethan M" sort="Weinberg, Ethan M" uniqKey="Weinberg E" first="Ethan M" last="Weinberg">Ethan M. Weinberg</name><name sortKey="Weinrieb, Robert M" sort="Weinrieb, Robert M" uniqKey="Weinrieb R" first="Robert M" last="Weinrieb">Robert M. Weinrieb</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/CovidStanfordV1/Data/Main/Exploration
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Ou
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Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= CovidStanfordV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= pubmed:33320417
|texte= The Stanford Integrated Psychosocial Assessment for Transplant is Associated with Outcomes Before and After Liver Transplantation.
}}
Pour générer des pages wiki
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| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a CovidStanfordV1
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