Department of Psychiatry and Behavioral Sciences.
Department of Medicine.
Curr Opin Organ Transplant. 2019 Dec;24(6):705-713. doi: 10.1097/MOT.0000000000000712.
The present review examines psychosocial factors emerging as predictive of clinical outcomes among solid organ transplant (SOT) recipients, with possible extensions to vascular composite allograft (VCA) and hand transplantation, in particular. The Chauvet Workgroup report and International Society of Heart and Lung Transplantation consensus guidelines are used to delineate areas of commonality between SOT and VCA, as well as unique features contributing to post-VCA psychosocial risk.
Increasing evidence suggests that depression, cognitive function, and other posttransplant psychosocial factors consistently associate with clinical risk in SOT. However, the mechanisms precipitating these psychosocial risk factors are likely diverse in their cause, with large individual differences across SOT and VCA. Transdiagnostic dimensions may serve as mechanistic factors, increasing the risk of adverse clinical outcomes and suggesting potential treatment strategies for risk mitigation. Psychosocial dimensions including psychological flexibility, self-efficacy, and posttraumatic growth are discussed as potential contributory factors.
Psychosocial factors hold importance in predicting posttransplant clinical outcomes. Emerging transdiagnostic factors may provide insight into mechanisms and potential treatments.
本综述考察了在实体器官移植（SOT）受者中，作为临床结果预测因子的心理社会因素，特别是在血管复合移植物（VCA）和手移植中。Chauvet 工作组报告和国际心肺移植学会共识指南用于描绘 SOT 和 VCA 之间的共同领域，以及导致 VCA 后心理社会风险的独特特征。
越来越多的证据表明，抑郁、认知功能和其他移植后心理社会因素与 SOT 的临床风险一致相关。然而，引发这些心理社会风险因素的机制在其原因上可能是多种多样的，在 SOT 和 VCA 之间存在很大的个体差异。跨诊断维度可能作为机制因素，增加不良临床结果的风险，并提示潜在的风险缓解治疗策略。讨论了心理社会维度，包括心理灵活性、自我效能感和创伤后成长，作为潜在的促成因素。
心理社会因素在预测移植后临床结果方面具有重要意义。新兴的跨诊断因素可能为机制和潜在治疗提供见解。
