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Can Pre-Transplant Psychometric Testing Predict Tacrolimus Intrapatient Variability After Living Kidney

Ah Rah Lee1, Sang Min Lee1, Won Sub Kang1

  • 1Department of Psychiatry, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea.

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|August 1, 2024
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Summary
This summary is machine-generated.

Pre-transplant psychometric testing using the MMPI-2 can predict high tacrolimus intrapatient variability (Tac IPV) in kidney transplant recipients. This finding may help identify patients at higher risk for post-transplant complications.

Keywords:
Intrapatient variabilityKidney transplantationMinnesota Multiphasic Personality Inventory-2RecipientsTacrolimus

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Area of Science:

  • Nephrology
  • Immunology
  • Psychology

Background:

  • Tacrolimus intrapatient variability (Tac IPV) is a known risk factor for outcomes after kidney transplantation.
  • Predicting Tac IPV before transplantation is crucial for personalized patient management.

Purpose of the Study:

  • To investigate the utility of pre-transplant psychometric testing in predicting Tac IPV after living kidney transplantation.
  • To identify specific psychological factors associated with high Tac IPV.

Main Methods:

  • 102 living kidney transplant recipients underwent pre-transplant Minnesota Multiphasic Personality Inventory-2 (MMPI-2) testing.
  • Recipients were categorized into low IPV (L-IPV) and high IPV (H-IPV) groups based on Tacrolimus levels.
  • Statistical analyses, including logistic regression and ROC curves, were used to assess the association between MMPI-2 scales and Tac IPV.

Main Results:

  • Hysteria (Hy), depression (D), and paranoia (Pa) MMPI-2 scale scores were significantly associated with high Tac IPV.
  • Specific cutoff values for Hy, D, and Pa scales were identified as predictors of high Tac IPV.
  • The predictive models demonstrated good statistical power (F1 scores of 0.70-0.71).

Conclusions:

  • Pre-transplant MMPI-2 profiles can serve as a valuable tool for predicting high Tac IPV in living kidney transplant recipients.
  • Psychological assessment may aid in identifying patients who could benefit from closer post-transplant monitoring.