Characterization of the Stanford Integrated Psychosocial Assessment for Transplant for Heart, Liver, and Kidney Transplant Candidates in Japan

Abstract

Background The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a comprehensive psychosocial assessment proven useful for predicting the outcomes of organ transplantation and is expected to be used in Japan. However, the characteristics of organ-specific SIPAT scores for organ transplant recipient candidates in Japan are unclear, and to date the SIPAT has not been properly utilized in clinical practice. The purpose of this study was to present relevant data that can be used to establish the criteria for accurately assessing the risk of post-transplant outcomes and the current status of psychosocial support by examining the SIPAT scores and distribution of organ transplant recipient candidates in Japan as well as organ-specific characteristics. Methods This study included 167 transplant recipient candidates (25 heart, 71 liver, and 71 kidney) who completed a semi-structured interview based on the Japanese version of the SIPAT (J-SIPAT) prior to transplantation. The differences between organs in terms of SIPAT scores and differences in SIPAT scores based on demographic data were comparatively analyzed. Results The total SIPAT scores were higher for liver recipient candidates than for heart recipient candidates (P = .019). Regarding the subscales, SIPAT B (social support system) scores were higher for liver and kidney recipient candidates than for heart recipient candidates (P = .021); SIPAT C (psychological stability and psychopathology) scores were higher for liver recipient candidates than for kidney recipient candidates (P = .002). Recipient candidates with a history of psychiatric treatment and those who were unemployed had higher SIPAT scores, regardless of the transplant organ, than recipient candidates without a history of psychiatric treatment and those who were employed (P < .001, P = .016). Conclusions There were notable differences in the total J-SIPAT and subscale scores among the liver, heart, and kidney recipient candidates. Each organ was associated with specific psychosocial issues that should be addressed before transplantation. Interventions such as information provision and patient education based on SIPAT assessment results for each organ may improve recipient post-transplant outcomes.