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一种评估对肝移植受者心理社会影响的创新方法:对应分析预测法。

An Innovative Approach to Assessing the Psychosocial Impacts on Liver Transplant Recipients: The Prediction-by-correspondence Analysis.

作者信息

Kim Se-Kang, Annunziato Rachel A

机构信息

Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.

Department of Psychology, Fordham University, Bronx, NY, USA.

出版信息

J Clin Exp Hepatol. 2025 Jan-Feb;15(1):102418. doi: 10.1016/j.jceh.2024.102418. Epub 2024 Sep 25.

Abstract

BACKGROUND

Innovative analytic techniques are applied to the psychological functioning of liver transplant (LT) recipients to comprehend its effect on post-transplant survival, hypothesizing that adherence will be predicted by psychosocial functioning.

METHODS

The psychosocial functioning of 248 LT recipients (88 females) aged 19 to 74 is assessed using the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT). In addition, the Medication Level Variability Index (MLVI) and biopsy-proven rejection are utilized to evaluate successful adherence. The Z-scores of the SIPAT scores are used to transform them into an ordinal variable with excellent, good, minimally acceptable, and poor categories. We employ a modified version of correspondence analysis to predict the binary MLVI and rejection, which signify either success or failure in adherence, using ordinal MLVI categories as predictors.

RESULTS

The excellent SIPAT category for LT beneficiaries was strongly related to adherence, whereas the minimally acceptable SIPAT was strongly related with failure in adherence. Females, ages 19-50, and ages 67-74 were associated with adherence (r = 0.49-1.00), whereas males and ages 56-60 were associated with failure in adherence (r = 0.43-0.91).

CONCLUSION

The clinical implications and utility of the novel analytic approaches introduced in the study are discussed.

摘要

背景

创新分析技术被应用于肝移植(LT)受者的心理功能,以理解其对移植后生存的影响,并假设心理社会功能将预测依从性。

方法

使用斯坦福移植综合心理社会评估(SIPAT)对248名年龄在19至74岁之间的LT受者(88名女性)的心理社会功能进行评估。此外,用药水平变异指数(MLVI)和活检证实的排斥反应被用于评估成功的依从性。SIPAT分数的Z分数被用来将其转换为一个有序变量,分为优秀、良好、勉强可接受和差四类。我们采用对应分析的修改版本,以有序的MLVI类别作为预测因子,预测二元MLVI和排斥反应,这表示依从性的成功或失败。

结果

LT受者的优秀SIPAT类别与依从性密切相关,而勉强可接受的SIPAT与依从性失败密切相关。19至50岁以及67至74岁的女性与依从性相关(r = 0.49 - 1.00),而男性和56至60岁的人则与依从性失败相关(r = 0.43 - 0.91)。

结论

讨论了该研究中引入的新型分析方法的临床意义和实用性。

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本文引用的文献

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The Utility of a Pre-Transplant Psychosocial Evaluation in Predicting Post-Liver Transplant Outcomes.
Prog Transplant. 2021 Mar;31(1):4-12. doi: 10.1177/1526924820978605. Epub 2020 Dec 4.
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Why It is Important to Consider Social Support When Assessing Organ Transplant Candidates?
Am J Bioeth. 2019 Nov;19(11):1-8. doi: 10.1080/15265161.2019.1671689.
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Gaining from discretization of continuous data: The correspondence analysis biplot approach.
Behav Res Methods. 2019 Apr;51(2):589-601. doi: 10.3758/s13428-018-1161-1.
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Pretransplant Psychosocial Risk Factors May Not Predict Late Nonadherence and Graft Rejection in Adult Liver Transplant Recipients.
Exp Clin Transplant. 2018 Oct;16(5):533-540. doi: 10.6002/ect.2016.0349. Epub 2017 Sep 30.

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