INSERM U 669, Paris XI University, Psychiatry Department, Bicêtre University Hospital, Assistance Publique—Hopitaux de Paris, Paris, France.
J Psychosom Res. 2011 Jul;71(1):32-7. doi: 10.1016/j.jpsychores.2010.12.008. Epub 2011 Mar 15.
Depressive symptoms are common after liver transplantation (LT). We studied whether depressive symptoms affect long-term survival after LT.
In a prospective cohort study, 134 liver transplant patients were assessed for depressive symptoms using the Beck Depression Inventory-short form (BDI), focusing on the 3 months post-LT score and on the score change from the waiting list period. They were followed up for long-term survival. The median duration of the follow-up period was 43 months post-LT. None of the 134 patients was lost to follow-up for survival.
A total of 33.6% of the LT patients had mild to moderate depressive symptoms 3 months post-LT. Eighteen (13.4%) patients died during the follow-up. Using Cox proportional hazards analysis, depressive symptoms were significantly associated with mortality (hazard ratio [HR] 1.22, 95% confidence interval (CI) 1.07-1.40, P<.003), one more point in the BDI score being associated with a 17% increase in mortality risk. Other predictive factors of mortality were older age and hepatitis C virus with recurrence 3 months post-LT. Similarly, an increase in depressive symptoms between the waiting list and 3 months post-LT periods predicted mortality (HR 1.18, 95% CI 1.01-1.38, P=.03), especially for patients without depressive symptoms on waiting list (HR 1.56, 95% CI 1.16-2.12, P=.004).
Depressive symptoms after LT and an increase in depressive symptoms between the waiting list and post-LT are associated with an increased risk of long-term mortality. Interventions that could reduce depressive symptoms could potentially decrease long-term mortality after LT.
肝移植（LT）后常出现抑郁症状。我们研究了抑郁症状是否影响 LT 后的长期生存。
在一项前瞻性队列研究中，使用贝克抑郁量表短式（BDI）评估了 134 例肝移植患者的抑郁症状，重点关注 LT 后 3 个月的评分和从等待名单期到 LT 后 3 个月的评分变化。对他们进行了长期生存随访。LT 后中位随访时间为 43 个月。无 134 例患者因生存而失访。
LT 患者中有 33.6%在 LT 后 3 个月时出现轻度至中度抑郁症状。18 例（13.4%）患者在随访期间死亡。使用 Cox 比例风险分析，抑郁症状与死亡率显著相关（风险比[HR]1.22，95%置信区间[CI]1.07-1.40，P<.003），BDI 评分每增加 1 分，死亡率风险增加 17%。死亡率的其他预测因素是年龄较大和 LT 后 3 个月时丙型肝炎病毒复发。同样，等待名单和 LT 后 3 个月期间抑郁症状的增加预测死亡率（HR 1.18，95%CI 1.01-1.38，P=.03），尤其是对于等待名单上无抑郁症状的患者（HR 1.56，95%CI 1.16-2.12，P=.004）。
LT 后抑郁症状以及等待名单和 LT 后期间抑郁症状的增加与长期死亡率增加相关。可能减少抑郁症状的干预措施可能会降低 LT 后的长期死亡率。
