*Purpose: The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) tool is employed in candidate evaluation. SIPAT scoring and association with outcomes post liver transplant (LT) require further study. Primary aim: examine LT outcomes with implementation of SIPAT during candidate evaluation. Secondary aim: assess demographic differences among pre-LT SIPAT score assignments.

*Methods: Retrospective review of 1-year outcomes in LT recipients with pre-LT SIPAT assessment. Outcomes in the SIPAT cohort compared to historical cohort of consecutive LT recipients immediately prior to SIPAT implementation. Demographics and post-LT outcomes between historical and SIPAT compared: surgical length of stay (LOS), episodes of biopsy proven rejection (ACR), number of hospitalizations, 1-year graft/patient survival; number of missed/attended ambulatory clinic encounters, and substance abuse relapse. T-test for differences between historical and SIPAT; in the SIPAT administered cohort Fisher’s exact test for comparisons of categorical distributions and one-way ANOVA for differences in means; p<0.05 significant.

*Results: 147 LT recipients: 74 historical and 73 SIPAT administered. Apart from age [historical vs SIPAT, mean +/- SD, p]: 53.3+/-11.6 yrs vs. 57.2+/-10.3, p=0.03; no significant demographic differences existed including BMI, gender, blood group, ethnicity, etiology of cirrhosis, or presence of hepatocellular cancer. Overall 1-year survival during the study interval was 91.2% (133/147) with no difference between historical 89.2% (66/74) and SIPAT 93.2% (68/73). Graft survival, number of hospitalizations, ACR, and substance relapse similar. Ambulatory clinic session attendance: 1.8 +/-1.6 vs 3.8 +/- 2.4, p<0.01 higher in SIPAT. In the SIPAT cohort (n=73): 15 (20.6%) excellent candidates, 41 (56.2%) good, and 17 acceptable/poor (23.3%). Excellent candidates were older [excellent vs good vs poor/acceptable, mean +/- SD, p]: 63.1+/-8.2 yrs vs 56.4+/-10.9 vs 54.1+/-8.6, p=0.03; Caucasian: 73.3% vs 48.8% vs. 35.3%, p=0.01; had less alcohol related disease: 6.7% vs 51.2% vs 70.6%, p=0.01; and trended towards less relapse: 0% vs. 7.3% vs. 23.5%, p=0.08. No significant difference existed among SIPAT groups with respect to LOS, ACR, number of hospitalizations, graft and patient survival at 1 year.

*Conclusions: SIPAT scoring is associated with post-LT clinic compliance. Age and ethnicity may influence pre-LT evaluation highlighting the need for complimentary approaches in psychosocial risk assessment, particularly in minority LT candidates.

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