2013 - ISBTS 2013 Symposium

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Mini-Oral Communications 2

26.351 - Relationship between pre transplant psychosocial diagnosis and post transplant adherence

Presenter: Luis, Moulin, , Argentina
Authors: Silvia Moscoloni², Liliana Martinez², Carolina Rumbo¹, Constanza EchevarrÃa¹, Gabriel Eduardo Gondolesi¹

Relationship between pre transplant psychosocial diagnosis and post transplant adherence

Silvia Moscoloni², Liliana Martinez², Carolina Rumbo¹, Constanza EchevarrÃa¹, Gabriel Eduardo Gondolesi¹

¹Multiorgan Transplant Institute, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina; ²Psychopathology, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina

Introduction

The pre intestinal transplant (ITx) evaluations (E) are performed by an interdisciplinary team. The psychosocial status (PS) is one of the variables analyzed to assess the patient (P) and his family response to post-ITx treatment giving an opportunity to modify pre transplant risk factors, trying to improve post-ITx adherence and results.

Objective

To analyze the relationship between the PS, post-ITx adherence and mortality.

Material and methods:

This is a retrospective chart review of 33 patients (pediatric and adult) transplanted between 03/2006 and 01/2013. Pre ITx PS E, Post-ITx adherence and mortality are analyzed. All PS E were performed by individual, family and home diagnostic interviews evaluating the following: lack of social and family support, pre ITx treatment discontinuation, economic difficulties, increased anxiety or depression levels, acute neurosis, severe personality disorders, active or background substance abuse , triggered psychosis.

Results:

Of the 33 P, 26, who are analyze, were discharge home after ITx.. 30% had PS, 42% died after leaving hospital, 21% had adherence difficulties The following correlation was significant: Psychosocial Risk (PSR) and postITx adherence (p<0,049). The positive predictive value of psychosocial-adherence risk was 86 %..There is no significant value between PSR and mortality, We identify variables that are not patient related that can influence on adherence such as medications shortage, lack of health insurance and others that are solved with Institutional support, and constitute a different category for further analysis.

Conclusion

PS evaluation constitutes a key part of the evaluation process that can affect post-ITX adherence, patient survival and program results, there for itself should have the strength to be a contraindication for ITx process.

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