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.
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.
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).
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.
This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 December 2020.
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#3,345,583
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#305
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#83,433
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Outputs of similar age from Liver Transplantation
#13
of 43 outputs
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