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Education Strategies

Tuesday September 13, 2022 - 17:35 to 18:35

Room: CF-6

345.9 Keeping up with psychosocial predictors of outcomes in solid organ transplantation: a user friendly interface to identify, organize and facilitate access to empirical data.

Monica Orendain Tremear, Canada

Clinical Psychologist
Solid Organ Transplant clinic at Vancouver General Hospital
Vancouver Coastal Health

Abstract

Keeping up with psychosocial predictors of outcomes in solid organ transplantation: a user friendly interface to identify, organize and facilitate access to empirical data

Boaz Y Saffer3, Madelaine Gierc2, Quincy Young2, Monica Orendain1.

1Solid Organ Transplant , Vancouver General Hospital, Vancouver, BC, Canada; 2Heart Centre, St. Paul's Hospital, Vancouver, BC, Canada; 3Department of Psychology, University of British Columbia, Vancouver, BC, Canada

Introduction: Psychosocial factors in solid organ transplantation have been identified as predictors of transplant outcomes such as morbidity, mortality and quality of life. Given the scarcity of available organs, systematic identification of psychosocial factors affecting outcomes is crucial for determining patient suitability for transplant, as well as reducing the risk of post-transplant complications via targeted interventions. Hundreds of individual studies and dozens of meta-analyses have quantified the impact of psychosocial variables on post-transplant outcomes. Sourcing this data, interpreting it, and systematically applying it within transplant settings is challenging due to the sheer amount of information available and lack of a system for organizing findings. Consequently, it is difficult to rigorously apply these findings to decision making for transplant suitability and patient care. The current study represents a step towards identifying, organizing and facilitating access to empirical data for the betterment of decision making and optimizing care.

Method: The study involved a systematic review of meta-analyses and systematic reviews. Electronic searches were performed using PubMed, Medline OVID, PsycINFO and Web of Science. Inclusion criteria included systematic reviews and meta-analyses in English, adult population of transplant recipients, and inclusion of psychosocial outcomes.

Results: Twenty-six studies met criteria for inclusion, 16 of them were systematic reviews and 10 meta-analyses. Studies included 193 data points (17 heart, 27 kidney, 89 liver, 19 lung and 41 multiple organs). Predictor variables included 26 behavioural (e.g., physical activity, medication adherence, sleep); 46 demographic (e.g., age, gender); 31 psychiatric (e.g., anxiety, depression); 25 social (e.g., social support, marital status); 57 substance use (e.g., alcohol dependence); 8 vocational (e.g., employment status). Outcome variables included 26 medical (e.g., late acute rejection); 27 mortality/survival; 87 substance use (e.g., high risk alcohol use); 20 psychological (e.g., PTSD, anxiety); 8 quality of life; 18 behavioural (e.g., medication adherence) and 7 miscellaneous. The data have been organized in user-friendly spreadsheets that allow the user to look for the information by organ, risk factors and outcomes.

Conclusion: The goal of this study was to create a user-friendly interface to determine the impact of psychosocial predictors on post-transplant outcomes based on empirical data. As newer, appropriate studies arise they will be added to maintain an up-to-date interface. This will assist informed decision-making regarding transplant candidacy and guide interventions both pre and post-transplant to optimize outcomes.

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