G Dieplinger1, N Mokhaberi2, R Wahba3, S Peltzer2, D Buchner3, H A Schlösser3, V Ditt4, A von Borstel4, U Bauerfeind4, U Lange5, W Arns5, C Kurschat6, D L Stippel3, F Vitinius2. 1. Department of General, Visceral, and Cancer Surgery, Transplant Center Cologne, University of Cologne, Cologne, Germany. Electronic address: georg.dieplinger@uk-koeln.de. 2. Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Cologne, Germany. 3. Department of General, Visceral, and Cancer Surgery, Transplant Center Cologne, University of Cologne, Cologne, Germany. 4. Institute for Clinical Transfusion Medicine, Transplant Center Cologne, Merheim Medical Center, Cologne General Hospital, Cologne, Germany. 5. Renal Division, Department of Medicine, Transplant Center Cologne, Merheim Medical Center, Cologne General Hospital, Cologne, Germany. 6. Renal Division, Department II of Internal Medicine, Transplant Center Cologne, University of Cologne, Cologne, Germany.
Abstract
BACKGROUND: Pretransplant psychosocial evaluation of living-donor kidney transplantation (LDKT) candidates identifies recipients with potentially inferior posttransplant outcomes. Rating instruments, based on semi-standardized interviews, help to improve and standardize psychosocial evaluation. The goal of this study was to retrospectively investigate the correlation between the Transplant Evaluation Rating Scale (TERS) and transplant outcome in LDKT recipients. METHODS: TERS scores were retrospectively generated by 2 raters based on comprehensive interviews of 146 LDKT recipients conducted by mental health professionals (interrater reliability, 0.8-0.9). All patients were eligible for transplantation according to pretransplant psychosocial evaluation. Patients were classified into 2 groups according to their TERS scores, in either two thirds excellent risk (TERS <29) and one third at least moderate risk (TERS ≥29) candidates. Analyzed medical parameters were change in estimated glomerular filtration rate and acute rejection (AR) episodes within the first year posttransplant. In addition, a subgroup of 65 patients was tested for de novo donor-specific HLA antibodies (DSA) posttransplant. RESULTS: There was no significant difference between the excellent (n = 97) and at least moderate (n = 49) risk candidates according to TERS in terms of organ function (estimated glomerular filtration rate decline >25%: 17 of 97 vs 11 of 49; P = .51) and episodes of AR (19 of 97 vs 15 of 49; P = .15). Patients developing de novo DSA (n = 18 [28%]) did not have higher pretransplant TERS scores (DSA positive, 11 of 42 vs 7 of 23; P = .78). CONCLUSIONS: Classifying LDKT recipients according to TERS score did not predict medical outcome at 1 year posttransplant or the occurrence of de novo DSA.
BACKGROUND: Pretransplant psychosocial evaluation of living-donor kidney transplantation (LDKT) candidates identifies recipients with potentially inferior posttransplant outcomes. Rating instruments, based on semi-standardized interviews, help to improve and standardize psychosocial evaluation. The goal of this study was to retrospectively investigate the correlation between the Transplant Evaluation Rating Scale (TERS) and transplant outcome in LDKT recipients. METHODS: TERS scores were retrospectively generated by 2 raters based on comprehensive interviews of 146 LDKT recipients conducted by mental health professionals (interrater reliability, 0.8-0.9). All patients were eligible for transplantation according to pretransplant psychosocial evaluation. Patients were classified into 2 groups according to their TERS scores, in either two thirds excellent risk (TERS <29) and one third at least moderate risk (TERS ≥29) candidates. Analyzed medical parameters were change in estimated glomerular filtration rate and acute rejection (AR) episodes within the first year posttransplant. In addition, a subgroup of 65 patients was tested for de novo donor-specific HLA antibodies (DSA) posttransplant. RESULTS: There was no significant difference between the excellent (n = 97) and at least moderate (n = 49) risk candidates according to TERS in terms of organ function (estimated glomerular filtration rate decline >25%: 17 of 97 vs 11 of 49; P = .51) and episodes of AR (19 of 97 vs 15 of 49; P = .15). Patients developing de novo DSA (n = 18 [28%]) did not have higher pretransplant TERS scores (DSA positive, 11 of 42 vs 7 of 23; P = .78). CONCLUSIONS: Classifying LDKT recipients according to TERS score did not predict medical outcome at 1 year posttransplant or the occurrence of de novo DSA.
Authors: Ersilia M DeFilippis; Khadijah Breathett; Elena M Donald; Shunichi Nakagawa; Koji Takeda; Hiroo Takayama; Lauren K Truby; Gabriel Sayer; Paolo C Colombo; Melana Yuzefpolskaya; Nir Uriel; Maryjane A Farr; Veli K Topkara Journal: Circ Heart Fail Date: 2020-09-08 Impact factor: 8.790
Authors: Vanessa L Richards; Christopher K Johnson; Christopher D Blosser; Lena Sibulesky Journal: Ann Transplant Date: 2018-09-18 Impact factor: 1.530