Exploration of the Stanford Integrated Psychosocial Assessment for Transplantation With Psychosocial and Medical Outcomes in Kidney and Kidney-Pancreas Transplant Recipients.
INTRODUCTION
The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a psychometric instrument designed to assess patient risk for transplant. We investigated the association between SIPAT scores and demographic data with psychosocial and medical outcomes within a diverse kidney/kidney-pancreas transplant population.


DESIGN
The SIPAT was administered to all pretransplant candidates. A retrospective review of transplanted patients who had at least 6 months of follow-up was completed.


RESULTS
The sample included 136 patients: male (n = 77 [57%]) with a mean age of 47 years old. Thirty-eight percent were black (n = 51), 55% had less than a high school education (n = 74), and 65% had low socioeconomic status (n = 89). Statistical difference was found among SIPAT scores and substance use and support system instability (P = .035, P = .012). Females (P = .012) and patients with a history of psychopathology (P = .002) developed or had a relapse of psychopathology following transplant. Patients with more than a high school education (P = .025) and who were less than 30 years (P = .026) had higher rejection incidence rates. Risk factors for rehospitalizations included Hispanic race, diabetes, and low socioeconomic status (P = .036, P = .038, P = .014). African American/Black and male patients had higher incidence of infection events (P = .032, P = .049). Mortality and treatment nonadherence were not significantly associated with SIPAT scores or demographic variables.


CONCLUSION
The SIPAT was associated with posttransplant substance use and support system instability, while demographic variables were associated with the development and/or relapse of psychopathology, graft loss, rejection, infection events, and medical rehospitalizations. Revision of the SIPAT to include additional demographic components may lend to improved prediction of transplant outcomes.
['Chen|Gloria|G|0000-0002-4517-9070', 'Bell|Cynthia S|CS|', 'Loughhead|Penelope|P|', 'Ibeche|Bashar|B|', 'Bynon|John S|JS|', 'Hall|David R|DR|', 'De Golovine|Aleksandra|A|', 'Edwards|Angelina|A|', 'Dar|Wasim A|WA|']
D000328:Adult D001741:African Americans D000367:Age Factors D003920:Diabetes Mellitus D004522:Educational Status D005006:Ethnicity D005260:Female D006084:Graft Rejection D006085:Graft Survival D006630:Hispanic or Latino D006801:Humans D015994:Incidence D007239:Infections D016030:Kidney Transplantation D008297:Male D001523:Mental Disorders D008875:Middle Aged D016035:Pancreas Transplantation D010349:Patient Compliance D010359:Patient Readmission D057234:Preoperative Period D011594:Psychometrics D012189:Retrospective Studies D012923:Social Class D012944:Social Support D019966:Substance-Related Disorders D066027:Transplant Recipients D044465:Whites
kidney (allograft) function/dysfunction recipient selection risk assessment/risk stratification