Psychological risk factors for graft rejection among liver transplant recipients

Paola Aceto, Alfonso Wolfango Avolio, Salvatore Agnes, Rosaria Calia, Carlo Lai, Massimiliano Luciani, Carlo Saraceni

Risultato della ricerca: Contributo in rivistaArticolo in rivista

17 Citazioni (Scopus)


The purpose of this prospective study was to find psychological risk factors predicting acute, chronic, and psychological rejection in patients undergoing liver transplantation using Cognitive Behavioural Assessment (CBA-2.0). The primary scale included an assessment of fears, personality, obsessive-compulsive symptoms, state and trait anxiety, psychological reactions, and depression. We prospectively recruited 44 patients undergoing orthotopic liver transplantation (OLT). Exclusion criteria were: education level below secondary school, unstable clinical situation in an out-patient setting, fulminant hepatitis, psychotic disorders, neurocognitive deficits, dementia, serious mental retardation, current alcohol or drug abuse, recent ideation of or attempted suicide, and non-adherence to therapy. CBA-2.0 primary scale series of questionnaires were handed out to patients immediately after the medical examination, which had been performed to ascertain eligibility for OLT. Rejection (acute and/or chronic) was diagnosed according to clinical and histopathological criteria. Psychological rejection was diagnosed when patients declared, after transplantation, a refusal of the new organ which caused psychiatric symptoms requiring medical treatment and/or psychotherapy. Analysis of variance and logistic regression of psychological variables was performed to detect possible risk factors for each type of rejection. A greater fear of repulsive animals was able a predictor for an acute rejection episode (odds ratio=1.1; P<.05). No other psychological pretransplant predictor was noted for chronic or psychological rejection. In patients undergoing OLT, preoperative emotions of fear could predict an acute graft rejection episode. These findings imply that pre-OLT screening should include psychological factors in addition to traditional medical criteria with intervention in selected cases.
Lingua originaleEnglish
pagine (da-a)1123-1127
Numero di pagine5
RivistaTransplantation Proceedings
Stato di pubblicazionePubblicato - 2011


  • Acute Disease
  • Analysis of Variance
  • Anxiety
  • Chronic Disease
  • Depression
  • Fear
  • Graft Rejection
  • Humans
  • Italy
  • Liver Transplantation
  • Logistic Models
  • Obsessive-Compulsive Disorder
  • Odds Ratio
  • Personality
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Questionnaires
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome


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