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Liver transplantation: The impact of demographic, physical, and psychosocial and psychological factors on eligibility and outcome

Laura Elizabeth Robinson, University of Nebraska - Lincoln

Abstract

The need for liver transplantation has grown without a commensurate increase in the number of available donor organs (UNOS, 2002). Consequently, pretransplant evaluations examining the medical, psychosocial, and psychological appropriateness of individuals for liver transplantation have become commonplace (Engle, 2001). This study examined how factors assessed during the pre-transplant evaluation are related to both transplant eligibility and outcome. Eligibility was defined as having been placed on the UNOS transplant waiting list following the pre-transplant evaluation. Outcome was defined as both survival to transplant, once made eligible, and length of survival following transplantation. Three types of factors were examined by this study, including demographic (e.g., age, gender, race, relationship status, education, profession, employment), physical (e.g., blood type, liver disease diagnosis, other medical diseases), and psychosocial/psychological (e.g., drug and alcohol use, psychiatric diagnosis and treatment, scores on the Millon Behavioral Health Inventory scales). Information regarding each factor was collected from the files of 475 individuals who underwent a pre-transplant evaluation at the University of Nebraska Medical Center/Nebraska Health System between January 1, 1991 and March 1, 2001. Each type of variable was investigated both independently, as well as in combination with one another, for their impact on liver transplant eligibility and outcome. ^ Overall, results indicate that complex combinations of demographic, physical, and psychosocial/psychological variables were related to both eligibility and outcome. Additionally, many of the variables found to be significant (e.g., blood type, education) had not previously been identified within the literature as relevant to transplant eligibility or outcome. Further, the combinations of variables related to eligibility were discordant from those associated with outcome, suggesting that factors associated with being made eligible in this study were not relevant to transplant outcome. These results lend support to previous literature indicating the need for greater study of the relationships between multiple variables and transplantation, as well as prospective, longitudinal investigations of the impact of eligibility criteria on liver transplantation outcome. ^

Subject Area

Psychology, Clinical

Recommended Citation

Robinson, Laura Elizabeth, "Liver transplantation: The impact of demographic, physical, and psychosocial and psychological factors on eligibility and outcome" (2002). ETD collection for University of Nebraska - Lincoln. AAI3055288.
http://digitalcommons.unl.edu/dissertations/AAI3055288

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