The Perfect Candidate? The Stanford Integrated Psychosocial Assessment for Transplant

E. J. Henricksen¹, K. Stott², S. Ilango², Y. Moayedi³, K. Waddell⁴, H. I. Luikart⁴, J. Twiggs⁴, R. Lee¹, B. M. Zhang⁵, W. Hiesinger⁶, K. K. Khush⁴, J. J. Teuteberg⁴

¹Transplant, Stanford Healthcare, Stanford, CA, ²Social Work, Stanford Healthcare, Stanford, CA, ³Cardiology, University Health Network, Toronto, ON, Canada, ⁴Cardiology, Stanford University, Stanford, CA, ⁵Pathology, Stanford University, Stanford, CA, ⁶Cardiothoracic Surgery, Stanford University, Stanford, CA

Meeting: 2021 American Transplant Congress

Abstract number: 1184

Keywords: Heart transplant patients, Psychosocial, Screening

Topic: Clinical Science » Heart » Heart and VADs: All Topics

Session Information

Session Name: Heart and VADs: All Topics

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) is a tool used to objectify and enhance the pre-transplant psychosocial evaluation. We sought to assess whether the SIPAT score was associated with outcomes of acute cellular rejection (ACR), antibody mediated rejection (AMR) and graft survival after heart transplantation (HTx).

*Methods: This was a retrospective analysis of HTx recipients from 01/2012 to 12/2019 at a single institution. Patients were excluded if a SIPAT was not performed prior to transplant or moved to a different transplant center within the first-year post HTx. Post transplant outcomes analyzed included ACR (2R or greater), AMR and graft survival, stratified by a SIPAT score under 20 (acceptable) versus 20 or greater (minimally acceptable). Kaplan-Meier estimator was performed for ACR, AMR and graft survival. Chi-square and t-test were performed to analyze differences in demographics between SIPAT categories.

*Results: Overall 218 heart transplant recipients had a SIPAT evaluation. The median (IQR) SIPAT score was 15 (10-20.75) and 66 patients (30.3%) had a SIPAT score of 20 or greater. A SIPAT score of 20 or greater was not associated with an increased risk of graft loss (p-value = 0.6), ACR (p-value = 1), nor AMR (p-value = 0.2) (Figure 1). Female candidates (85.5% vs. 63.4%, p-value = 0.002) were more likely to have a SIPAT score under 20. Caucasians were also more likely to have a SIPAT score less than 20 (75.6% vs. 61.5%, p-value = 0.04). There was no difference in SIPAT scores for other baseline demographics.

*Conclusions: Carefully selected patients with a “minimally acceptable” SIPAT score did not experienced an increased risk of graft loss, AMR or ACR. While the SIPAT tool has become an integral part of the HTx evaluation, a high SIPAT score alone may not be sufficient to decline HTx candidates.

To cite this abstract in AMA style:

Henricksen EJ, Stott K, Ilango S, Moayedi Y, Waddell K, Luikart HI, Twiggs J, Lee R, Zhang BM, Hiesinger W, Khush KK, Teuteberg JJ. The Perfect Candidate? The Stanford Integrated Psychosocial Assessment for Transplant [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/the-perfect-candidate-the-stanford-integrated-psychosocial-assessment-for-transplant/. Accessed November 21, 2024.

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