Depressive symptoms predict long-term mortality after liver transplantation

Area of Science:

• Transplantation Medicine
• Psychiatry
• Clinical Outcomes Research

Background:

• Depressive symptoms are frequently observed in patients following liver transplantation (LT).
• The impact of these post-transplant depressive symptoms on long-term patient survival remains an area of significant clinical interest.

Purpose of the Study:

• To investigate the association between depressive symptoms occurring after LT and the long-term survival of transplant recipients.
• To determine if changes in depressive symptom scores from the waiting list to post-LT predict mortality.

Main Methods:

• A prospective cohort study involving 134 liver transplant patients.
• Assessment of depressive symptoms using the Beck Depression Inventory-short form (BDI) at 3 months post-LT and evaluation of score changes from the waiting list period.
• Long-term survival follow-up with a median of 43 months post-LT, ensuring no loss to follow-up.

Main Results:

• 33.6% of LT patients exhibited mild to moderate depressive symptoms at 3 months post-LT.
• Depressive symptoms were significantly associated with increased mortality (HR 1.22, P<.003), with each BDI point increase correlating to a 17% rise in mortality risk.
• An increase in depressive symptoms from waiting list to 3 months post-LT also predicted mortality (HR 1.18, P=.03), particularly in patients without pre-existing depressive symptoms.

Conclusions:

• Both the presence of depressive symptoms post-LT and an increase in these symptoms are linked to a higher risk of long-term mortality.
• Interventions aimed at reducing depressive symptoms after LT hold the potential to improve long-term survival rates for transplant recipients.