Impact of Psychosocial Variables on Renal Allograft Rejection Risk: A Multivariate Analysis
Transplant Surgery, Tulane University School of Medicine, New Orleans, LA.
Meeting: 2018 American Transplant Congress
Abstract number: B188
Keywords: Kidney transplantation, Psychosocial, Rejection, Risk factors
Session Information
Session Name: Poster Session B: Kidney Psychosocial
Session Type: Poster Session
Date: Sunday, June 3, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Transplant-specific risk factors for rejection are well documented, yet psychosocial variable correlation with rejection risk is not; this analysis seeks to determine the relationship between psychosocial variables and rejection outcomes.
Psychosocial data was collected from pre-transplant evaluation reports for patients transplanted from 2006-2016. Patients without psychosocial records were excluded. A multivariate logistic regression was performed using STATA software with rejection as the dependent variable.
Adequate drug coverage was significant for decreased rejection risk (OR=0.27,p<0.001), while lacking follow up compliance was significant for increased rejection risk (OR= 5.17, p<0.001). Other variables were not statistically significant.
| Total
N=517(%) |
Rejection
N=100(%) |
OR
R2=0.249 |
P Value | CI(95%) | |
| Non-Adherence | 173(33) | 42(42) | 0.49 | 0.06 | 0.23-1.03 |
| Lack Caregiver | 31(6) | 15(15) | 1.65 | 0.34 | 0.72-10.14 |
| Adequate Drug Coverage | 375(73) | 46(46) | 0.27 | <0.001 | 0.143-0.49 |
| No Transport | 48(9) | 18(18) | 0.67 | 0.43 | 0.26-1.75 |
| Cognitive Disability | 32(6) | 9(9) | 1.12 | 0.85 | 0.36-3.49 |
| Substance Abuse | 79(15) | 23(23) | 1.46 | 0.54 | 0.44-4.86 |
| Substance Abuse Suspected | 55(11) | 14(14) | 0.89 | 0.87 | 0.21-3.69 |
| Lack Routine Labs/ Follow Up | 175(34) | 69(69) | 5.17 | <0.001 | 2.45-10.94 |
| 1-yr Increase in Age (avg) | 49.00 | 42.76 | 0.98 | 0.03 | 0.96-1.00 |
| Male Gender | 288(56) | 59(59) | 1.40 | 0.26 | 0.78-2.50 |
| African American | 310(60) | 79(79) | 2.95 | 0.001 | 1.53-5.7 |
| Previous Transplant | 74(14) | 17(17) | 0.85 | 0.67 | 0.41-1.78 |
| Received GCSF/Filgrastim | 107(21) | 32(32) | 3.57 | <0.001 | 1.78-7.15 |
| Alemtuzumab Induction | 215(42) | 40(40) | 0.41 | 0.14 | 0.12-1.36 |
This analysis considers rejection risk in the setting of a multivariate analysis with other known risk factors for rejection. Both protective factors and risk factors were identified, showing that pre-transplant evaluation psychosocial factors impact post-transplant outcomes.
CITATION INFORMATION: Chernobylsky D., Carsky K., McDermott C., Ferrin P., Fernandez R., Gaines I., Killackey M., Zhang R., Paramesh A., Buell J. Impact of Psychosocial Variables on Renal Allograft Rejection Risk: A Multivariate Analysis Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Chernobylsky D, Carsky K, McDermott C, Ferrin P, Fernandez R, Gaines I, Killackey M, Zhang R, Paramesh A, Buell J. Impact of Psychosocial Variables on Renal Allograft Rejection Risk: A Multivariate Analysis [abstract]. https://atcmeetingabstracts.com/abstract/impact-of-psychosocial-variables-on-renal-allograft-rejection-risk-a-multivariate-analysis/. Accessed November 23, 2024.« Back to 2018 American Transplant Congress