Department of Psychology, University of Bologna, Italy.
Department of Experimental and Clinical Medicine, University of Florence, Italy.
Ann Hepatol. 2019 Nov-Dec;18(6):804-809. doi: 10.1016/j.aohep.2019.06.011. Epub 2019 Aug 20.
Liver transplant candidates and recipients are at high risk of psychological distress. Social, psychological and psychiatric patterns seem to influence morbidity and mortality of patients before and after transplant. An accurate organ allocation is mandatory to guarantee an optimal graft and recipient survival. In this context, the pre-transplant social, psychological and psychiatric selection of potential candidates is essential for excluding major psychiatric illness and for estimating the patient compliance. Depression is one of the most studied psychological conditions in the field of organ transplantation. Notably, an ineffectively treated depression in the pre-transplant period has been associated to a worst long-term recipient survival. After transplant, personalized psychological intervention might favor recovery process, improvement of quality of life and immunosuppressant adherence. Active coping strategy represents one of the most encouraging ways to positively influence the clinical course of transplanted patients. In conclusion, multidisciplinary team should act in three directions: prevention of mood distress, early diagnosis and effective treatment. Active coping, social support and multidisciplinary approach might improve the clinical outcome of transplanted patients.
肝移植候选者和受者存在较高的心理困扰风险。社会、心理和精神模式似乎会影响移植前后患者的发病率和死亡率。准确的器官分配是保证最佳移植物和受者存活的必要条件。在这种情况下，对潜在候选者进行移植前的社会、心理和精神选择对于排除严重精神疾病和评估患者依从性至关重要。抑郁是器官移植领域研究最多的心理状况之一。值得注意的是，移植前未得到有效治疗的抑郁与受者长期生存预后较差有关。移植后，个性化的心理干预可能有助于恢复过程、提高生活质量和免疫抑制剂的依从性。积极应对策略是对移植患者的临床病程产生积极影响的最有希望的方法之一。总之，多学科团队应从三个方向采取行动：预防情绪困扰、早期诊断和有效治疗。积极应对、社会支持和多学科方法可能会改善移植患者的临床转归。
