Background: The prevalence of bipolar disorder and schizophrenia combined is around 1-4% in the general population and both represent relative contraindications for kidney transplantation. However, the published data on post-transplant outcomes in patients with pre-transplant psychotic disorders are extremely limited.

Methods: We examined 3,680 US veterans who underwent kidney transplantation (including 717 preemptive transplantation) between 10/2007 and 09/2011. The diagnosis of either psychotic disorder was based on a validated algorithm. Measured confounders were used to create a propensity score-matched cohort. Associations between psychotic disorders and graft loss-censored death, all-cause death and death-censored graft loss were examined in Cox proportional hazard and competing risk regression models.

Results: The mean±SD age of the cohort at baseline was 61±11 years, 92% were male, 66% and 27% of patients were white and black, respectively, 72% were married, 48% of the patients were diabetic. Compared to patients without psychotic disorders, psychotic patients had similar graft loss-censored mortality risk in competing risk regression model [Sub-Hazard Ratio (SHR) (95% CI): 0.78 (0.36-1.69)]. Additionally, psychotic patients had similar all-cause mortality risk using Cox regression [HR (95% CI): 0.91 (0.45-1.86)]. Finally, compared to patients without psychotic disorders, psychotic patients had similar death censored graft loss risk using competing risk regression model [SHR (95% CI): 1.00 (0.42-2.37)]. Similar results were found in different subgroups.

Conclusions: Psychotic disorders are not associated with adverse outcomes in kidney transplant recipients.

CITATION INFORMATION: Molnar M., Eason J., Gaipov A., Talwar M., Potukuchi P., Kalantar-Zadeh K., Kovesdy C. Psychotic Disorders and Outcomes after Kidney Transplantation Am J Transplant. 2017;17 (suppl 3).

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