Kim Se-Kang, Annunziato Rachel A
Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Department of Psychology, Fordham University, Bronx, NY, USA.
J Clin Exp Hepatol. 2025 Jan-Feb;15(1):102418. doi: 10.1016/j.jceh.2024.102418. Epub 2024 Sep 25.
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.
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.
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).
The clinical implications and utility of the novel analytic approaches introduced in the study are discussed.
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。
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。
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）。
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。
