Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*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.
To cite this abstract in AMA style:Gomez P, Zucker K, Foote J, Thomas C, Anderson R, Nathan R, Mehta S, Patel N, Fallon M, Seetharam A. Performance Evaluation of the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) in Liver Transplant Candidates [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/performance-evaluation-of-the-stanford-integrated-psychosocial-assessment-for-transplantation-sipat-in-liver-transplant-candidates/. Accessed November 29, 2020.
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