Impact of Psychosocial Variables on Renal Allograft Rejection Risk: A Multivariate Analysis
D. Chernobylsky, K. Carsky, C. McDermott, P. Ferrin, R. Fernandez, I. Gaines, M. Killackey, R. Zhang, A. Paramesh, J. Buell.
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 October 11, 2024.« Back to 2018 American Transplant Congress