Psychological Assessment Instruments for Use in Liver and Kidney Transplant Evaluations: Scarcity of Evidence and Recommendations

Nghiem, Duyen M.; Gomez, Jocelyn; Gloston, Gabrielle F.; Torres, Debbie; Marek, Ryan J.

doi:10.1080/00223891.2019.1694527

Cited by 21 publications

(19 citation statements)

References 82 publications

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“…Additional attention, in comparison to directed donor evaluation, is focused on motivation, prior history of altruistic behavior in keeping with consistent motivation, as well as willingness to maintain anonymity. At UC, all donors are assessed for psychosocial risk using tools such as the Psychosocial Assessment of Candidates for Transplantation 29 and Personality Assessment Inventory (beginning 2018), which provides indices of psychopathology and personality disorders 30,31 . ND‐LLDs with a history of psychiatric conditions must be deemed low risk for complications postdonation prior to approval.…”

Section: Experimental Methodsmentioning

confidence: 99%

Health-related quality of life after anonymous nondirected living liver donation: A multicenter collaboration

Raza

Jackson²,

Dell

et al. 2021

American Journal of Transplantation

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Literature on living nondirected liver donation is sparse. The purpose of this study was to assess health‐related quality of life (HR‐QOL) in anonymous nondirected living liver donors (ND‐LLDs). ND‐LLDs at 3 centers: University of Alberta (n = 12), University of Colorado (n = 12), and University of Southern California (n = 12), were surveyed. Thirty donors (83%) responded to the Donor Quality of Life (USC DQLS) and Short‐Form 36 (SF‐36). Most respondents (n = 15, 50%) donated their left lateral segment, 27% right lobe, and 23% left lobe. The majority were female (67%) and mean age was 38.9 ± 11.2 years at donation. Median follow‐up was 1.1 (interquartile range 0.4‐3.3) years. Approximately 37% had previously donated a kidney. Eleven experienced ≥1 postoperative complication, with only 1 Clavien‐Dindo IIIb. Most reported minimal impact on school or work performance, all felt positive or neutral about their overall health since donation, and none expressed postdonation regrets. No donor reported impacts on health insurability, and 3 of 4 respondents attempting to purchase life insurance postdonation were successful. ND‐LLD SF‐36 outcomes were similar to US population norms. Overall, ND‐LLDs demonstrated acceptable HR‐QOL after donation and are appropriate candidates for partial liver donation. Based on evaluation of donation impact, consideration should be given to postdonation support strategies.

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Section: Experimental Methodsmentioning

confidence: 99%

Health-related quality of life after anonymous nondirected living liver donation: A multicenter collaboration

Raza

Jackson²,

Dell

et al. 2021

American Journal of Transplantation

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“…Above that we were able to generate further evidence supporting the construct and predictive validity of the factors of the TERS. As recommended by others there is a need for additional psychometric work in different transplant populations regarding instruments currently being used in practice (13).…”

Section: Discussionmentioning

confidence: 99%

“…Finally, we examined the predictive value of the TERS factors with regard to listing for lung transplantation and with regard to pulmonary quality of life 1 year after transplant. So far, information regarding the predictive validity of evaluation instruments for organ transplant candidates is scarce and further research in this field is much needed (13).…”

Section: Introductionmentioning

confidence: 99%

Factor Analyses and Validity of the Transplant Evaluation Rating Scale (TERS) in a Large Sample of Lung Transplant Candidates

et al. 2020

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Objective: It is well known that the occurrence of mental disorders is more common in lung transplant candidates compared to the general population. After transplantation mental disorders may negatively affect quality of life, adherence to immunosuppressive medication, as well as overall survival. Therefore, the identification of patients at risk is of utmost importance and in Germany pre-transplant psychosocial evaluation of the patients is required. To ensure high quality and comparability of these assessments, the use of psychometrically sound instruments is recommended. We applied the Transplant Evaluation Rating Scale (TERS), a broadly used expert interview. Two research groups have detected a two-factor structure of the TERS in different transplant samples; however, with slightly different results. The present study investigated which of the models would fit best in our sample of lung transplant patients. Additionally, we assessed convergent and predictive validity of the best fitting model to evaluate its clinical usefulness.Methods: Between 2016 and 2019, 390 lung transplant candidates were evaluated and included in the study. The median age was 53 years and 54% were male. TERS interviews were conducted by trained medical doctors and psychologists. The participants completed questionnaires assessing quality of life and levels of depression and anxiety. Transplant-and disease-specific variables (lung disease, listing date, oxygen use) were taken from the patient charts. Confirmatory factor analysis was used to test the two proposed TERS-models in the present sample. Results:The two-factor structure of the TERS reported by Hoodin and Kalbfleisch fit our sample best, showing good psychometric properties. The factor "emotional sensitivity" was highly correlated with quality of life and measures of psychosocial health while the factor "defiance" correlated with obstructive lung disease and older age but not with

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“…Though tools that assess transplant readiness are available, such as the Psychosocial Assessment of Candidates for Transplant (PACT), Stanford Integrated Psychosocial Assessment for Transplant (SIPAT), and Transplant Evaluation Rating Scale (TERS), it is unclear if they can be used as a standalone assessment. 18,19 The quantitative and predictive aspects of these scales have not been thoroughly evaluated and validated. Thus, while a threshold score on these scales cannot be used for deciding transplant candidacy, they can help standardize psychosocial evaluations.…”

Section: Implementation and Challengesmentioning

confidence: 99%

KDOQI US Commentary on the 2020 KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation

Puttarajappa

Schinstock

et al. 2021

American Journal of Kidney Diseases

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Evaluation of patients for kidney transplant candidacy is a comprehensive process that involves a detailed assessment of medical and surgical issues, psychosocial factors, and patients' physical and cognitive abilities with an aim of balancing the benefits of transplantation and potential risks of surgery and long-term immunosuppression. There is considerable variability among transplant centers in their approach to evaluation and decision-making regarding transplant candidacy. The 2020 KDIGO (Kidney Disease: Improving Guidelines Outcome) clinical practice guideline on the evaluation and management of candidates for kidney transplantation provides practice recommendations that can serve as a useful reference guide to transplant professionals. The guideline, covering a broad range of topics, was developed by an international group of experts from transplant and nephrology through a review of literature published until May 2019. A work group of US transplant nephrologists convened by NKF-KDOQI (National Kidney Foundation-Kidney Disease Quality Initiative) chose key topics for this commentary with a goal of presenting a broad discussion to the US transplant community. Each section of this article has a summary of the key KDIGO guideline recommendations, followed by a brief commentary on the recommendations, their clinical utility, and potential implementation challenges. The KDOQI work group agrees broadly with the KDIGO recommendations but also recognizes and highlights the decision-making challenges that arise from lack of high-quality evidence and the need to balance equity with utility of organ transplantation.Because they are designed to reflect the views and recommendations of the responsible KDOQI Commentary work group and they are reviewed and approved by KDOQI and NKF leadership, KDOQI Commentaries are not peer reviewed by AJKD. This article was prepared by a KDOQI Commentary work group comprising the authors and chaired by Dr Sundaram Hariharan. It was reviewed and approved by the NKF Scientific Advisory Board and the KDOQI Chair and Vice Chairs.Complete author and article information provided before references.

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Psychological Assessment Instruments for Use in Liver and Kidney Transplant Evaluations: Scarcity of Evidence and Recommendations

Cited by 21 publications

References 82 publications

Health-related quality of life after anonymous nondirected living liver donation: A multicenter collaboration

Health-related quality of life after anonymous nondirected living liver donation: A multicenter collaboration

Factor Analyses and Validity of the Transplant Evaluation Rating Scale (TERS) in a Large Sample of Lung Transplant Candidates

KDOQI US Commentary on the 2020 KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation

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