Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
- Evaluating the Predictive Utility of the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) for Post-Transplant Outcomes in Moderate to High-Risk Liver Transplant Candidates
- Exploration of the Stanford Integrated Psychosocial Assessment for Transplant with Psychosocial and Medical Outcomes in Kidney/Kidney-Pancreas Transplant Recipients
*Purpose: Psychosocial evaluation is an integral part of transplant recipient evaluation. SIPAT is a tool designed to assess psychological health of transplant candidates. Lower SIPAT score correspond to better psychosocial health and possibly better post-transplant outcomes. We hypothesize that candidates with favorable SIPAT score are more likely to be listed for transplant.
*Methods: A single center retrospective study of patients evaluated for kidney transplant from 3/1/2015 to 12/31/2017 was performed. Linear regression and Cox-proportional hazard ratio were conducted to analyze the interaction of SIPAT score and covariates with the outcome of the evaluation via SPSS 25®.
*Results: Of the 926 patients evaluated,the majority were males (60%),Caucasian (60%) and in a stable relationship (55%).The median age was 56 ± 12yrs with median household income (derived from ZIP code) of $49,000 ± 21,000. At the end of study,48% were listed,18% still in process, and 34% were ineligible. According to the SIPAT score, 69% were excellent or good, 25% minimally acceptable,and only 6% were high-risk or poor candidates for transplant. In a multivariate analysis,AA and lack of stable relationship status were independently associated with higher SIPAT score.
|Age at evaluation, y||-1.24||<0.001*||-1.25||0.2|
|Female (ref male)||1.28||0.1||0.05||0.9|
|AA (ref Caucasian)||3.36||<0.001*||2.20||0.005*|
|Stable relationship ( Ref) Divorced/Separated/Widow, Single||8.05 ,7.85||<0.001*, <0.001*||7.70 ,6.87||<0.001* ,<0.001*|
|Income (in $10,000)||-0.06||<0.001*||0.03||0.7|
Older age at evaluation and favorable SIPAT score were independently associated with higher odds of successful listing for kidney transplant whereas race, gender and income did not influence evaluation outcomes.
|Odds ratio||95% CI||P-value|
|Age at evaluation, y||1.01||1.007-1.030||0.01*|
|AA (ref Caucasian)||0.79||0.6-1.0||0.08|
|Stable Relationship (Ref) Divorced/Separated/Widow, Single||0.82, 1.05||0.6-1.1, 0.7-1.4||0.2, 0.7|
|Income (in $10,000)||0.99||0.9-1.005||0.7|
|SIPAT excellent candidate(Ref) Marginal candidate, High risk/poor candidate||2.61, 5.43||1.5-4.4, 3.0-9.7||<0.001*, <0.001*|
*Conclusions: Majority of the transplant candidates received a favorable SIPAT score and had higher odds of being listed. Although AA race and lack of stable life partner did negatively influence SIPAT scoring, they did not have an independent impact on likelihood of listing. SIPAT score is a useful tool for relevant assessment of recipient psychosocial health without restricting access to transplantation. The test could provide targets for intervention for improving overall psychosocial health and wellbeing of transplant candidates.
To cite this abstract in AMA style:Kumar A, Salaway J, Dorris M, Newman J, Doyle A, Rao S. Lower Stanford Integrated Psychosocial Assessment (SIPAT) for Transplantation Score is Predictive of Successful Listing for Kidney Transplant Candidates [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/lower-stanford-integrated-psychosocial-assessment-sipat-for-transplantation-score-is-predictive-of-successful-listing-for-kidney-transplant-candidates/. Accessed December 12, 2019.
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