Mental Health and Transplantation: Challenges and Solutions

A special issue of Transplantology (ISSN 2673-3943).

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 22582

Special Issue Editors


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Guest Editor
Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Villarroel, 170, 08036 Barcelona, Spain
Interests: transplant; mental health; addictions; alcohol use disorders; cannabis use disorders

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Guest Editor
1. Head of Consultation Liaison Psychiatry Unit at Hospital Clinico de Barcelona, School of Medicine of Barcelona University, Barcelona, Spain
2. Member of Research Institute IDIBAPS (Institut d’Investigacio Biomedica Augusto Pi i Sunyer), University of Barcelona, Barcelona, Spain
Interests: neuropsychiatry; psychological and psychiatric issuess in organ transplantation

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Guest Editor
Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS. RTA (RETICS). Villarroel, 170, 08036 Barcelona, Spain
Interests: transplant; mental health; addictions; alcohol use disorders; cannabis use disorders

Special Issue Information

Dear Colleagues,

Mental and physical health are interrelated in a complex way. About 10% of physical health is explained by past mental health and vice versa, in a bidirectional relationship. Psychological and social assessment is a relevant aspect covered in evaluation protocols for high complexity intervention such as functional neurosurgery (e.g., epilepsy, Parkinson disease) or transplantation (e.g., liver, heart). Mental health impacts on several transplantation outcomes: 1) adherence to immunosuppressive drugs and healthy lifestyles; 2) early and late complications (graft rejection, cancer, hospitalizations, etc.); 3) quality of life; 4) survival. Mental health includes severe mental health disorders, substance use disorders including alcohol and tobacco, personality traits and coping strategies, organic mental disorders (e.g., adverse reactions to medications, delirium, etc.), transplantation and disease as life-event with impact on mental health, etc.

Thus, the evaluation of mental health before transplantation is a key point in order to ensure the short-term and long-term success of this complex intervention. However, management of mental health issues during and after transplantation is also fundamental. Identifying candidates at risk of mental health complications before, during or after transplantation, and implementing strategies to help patients face these complications, allows us to widen our indications for transplantation.

This Special Issue calls for manuscripts that identify challenges and potential solutions to mental health assessment and management at any stage of transplantation. We expect that the body of evidence originated by this Special Issue will aid in expanding the indications of transplantation.

Dr. Hugo Lopez-Pelayo
Dr. Luis Pintor
Dr. Anna Lligoña
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Transplantology is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Mental health
  • Transplantation
  • Substance use disorder
  • Alcohol use disorder
  • Coping strategies
  • Organic mental disorders
  • Quality of life

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Published Papers (4 papers)

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Research

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7 pages, 532 KiB  
Article
Direct Alcohol Biomarkers Prediction Capacity on Relapse and Mortality in Liver Transplantation Candidates: A Follow-Up Study
by Pablo Barrio, Oriol Marco, Mauro Druetta, Laia Tardon, Anna Lligonya, Friedrich Martin Wurst, Wolfgang Weinmann, Michel Yegles and Antoni Gual
Transplantology 2021, 2(3), 246-252; https://doi.org/10.3390/transplantology2030023 - 23 Jun 2021
Viewed by 2303
Abstract
Liver transplantation is a complex procedure that requires multiple evaluations, including abstinence monitorization. While literature assessing the impact of different variables on relapse, survival, and graft loss exists, little is known about the predictive capacity of direct alcohol biomarkers. The primary aim of [...] Read more.
Liver transplantation is a complex procedure that requires multiple evaluations, including abstinence monitorization. While literature assessing the impact of different variables on relapse, survival, and graft loss exists, little is known about the predictive capacity of direct alcohol biomarkers. The primary aim of this study was to evaluate the prediction capacity of direct alcohol biomarkers regarding patient survival and clinical relapse. We hypothesized that patients screening positive for any of the experimental biomarkers would show an increased risk of clinical alcohol relapse and death. We conducted a retrospective data recollection from medical files of patients awaiting liver transplantation, who were at baseline screened with Peth, EtG in hair and urine, and EtS. We tested the prediction capacity of the biomarkers with two Cox-regression models. A total of 50 patients were included (84% men, mean age 59 years (SD = 6)). Biomarkers at baseline were positive in 18 patients. The mean follow-up time for this study was 26 months (SD = 10.4). Twelve patients died, liver transplantation was carried out in 12 patients, and clinical relapse was observed in eight patients. The only significant covariate in the Cox-regression models was age with clinical relapse, with younger patients being at greater risk of relapse. This study could not find a significant prediction capacity of direct alcohol biomarkers for mortality or clinical relapse during follow-up. Higher sample sizes might be needed to detect statistically significant differences. All in all, we believe that direct alcohol biomarkers should be widely used in liver transplantation settings due to their high sensitivity for the detection of recent drinking. Full article
(This article belongs to the Special Issue Mental Health and Transplantation: Challenges and Solutions)
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14 pages, 715 KiB  
Article
“You Can’t Manage What You Can’t Measure”: Perspectives of Transplant Recipients on Two Lifestyle Interventions for Weight Management
by Suzanne Anderson, Catherine Brown, Katherine Venneri, Justine R. Horne, June I. Matthews and Janet E. Madill
Transplantology 2021, 2(2), 210-223; https://doi.org/10.3390/transplantology2020020 - 4 Jun 2021
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Abstract
Previous research suggests that effective lifestyle interventions for solid organ transplant (SOT) recipients must be tailored to address the unique life circumstances of this population. As few studies have investigated this design consideration, this study aimed to explore the perspectives and experiences of [...] Read more.
Previous research suggests that effective lifestyle interventions for solid organ transplant (SOT) recipients must be tailored to address the unique life circumstances of this population. As few studies have investigated this design consideration, this study aimed to explore the perspectives and experiences of SOT recipients after completing a Group Lifestyle Balance™ [GLB]-based intervention incorporating either (a) standard population-based nutrition guidance or (b) nutrigenomics-based nutrition guidance. All active participants in the Nutrigenomics, Overweight/Obesity, and Weight Management-Transplant (NOW-Tx) pilot study were invited to participate. Data were collected through focus groups and individual interviews. Ninety-five percent (n = 18) of the NOW-Tx pilot study participants enrolled in the current study: 15 participated in 3 focus groups; 3 were interviewed individually. Three themes were common to both intervention groups: (1) the post-transplant experience; (2) beneficial program components; (3) suggestions for improvement. A unique theme was identified for the nutrigenomics-based intervention, comprising the sub-themes of intervention-specific advantages, challenges, and problem-solving. The readily available and adaptable GLB curriculum demonstrated both feasibility and acceptability and was aligned with participants’ needs and existing health self-management skills. The addition of nutrigenomics-based guidance to the GLB curriculum may enhance motivation for behaviour change in this patient population. Full article
(This article belongs to the Special Issue Mental Health and Transplantation: Challenges and Solutions)
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12 pages, 253 KiB  
Article
Psychosocial Dimensions in Hemodialysis Patients on Kidney Transplant Waiting List: Preliminary Data
by Yuri Battaglia, Luigi Zerbinati, Elena Martino, Giulia Piazza, Sara Massarenti, Alda Storari and Luigi Grassi
Transplantology 2020, 1(2), 123-134; https://doi.org/10.3390/transplantology1020012 - 15 Dec 2020
Cited by 5 | Viewed by 3182
Abstract
Although the donation rate for deceased and living kidneys has been increasing, the donor organ availability meets only the 30% of kidney needs in Italy. Consequently, hemodialysis patients stay for a long time, an average of 3.2 years, on a waiting list for [...] Read more.
Although the donation rate for deceased and living kidneys has been increasing, the donor organ availability meets only the 30% of kidney needs in Italy. Consequently, hemodialysis patients stay for a long time, an average of 3.2 years, on a waiting list for a kidney transplant with consequent relevant psychological distress or even full-fledged psychiatric disorders, as diagnosed with traditional psychiatric nosological systems. Recent studies report, however, a higher prevalence of other psychosocial syndromes, as diagnosed by using the Diagnostic Criteria for Psychosomatic Research (DCPR) in medically ill and kidney transplant patients. Nevertheless, no data regarding DCPR prevalence are available in patients waitlisted for a renal transplant (WKTs). Thus, the primary aim of this study was to identify sub-threshold or undetected syndromes by using the DCPR and, secondly, to analyze its relationship with physical and psychological symptoms and daily-life problems in WKTs. A total of 30 consecutive WKTs were assessed using the DCPR Interview and the MINI International Neuropsychiatric Interview 6.0. The Edmonton Symptom Assessment System (ESAS) and the Canadian Problem Checklist were used to assess physical and psychological distress symptoms and daily-life problems. A total of 60% of patients met the criteria for at least one DCPR diagnosis; of them, 20% received one DCPR diagnosis (DCPR = 1), and 40% more than one (DCPR > 1), especially the irritability cluster (46.7%), Abnormal Illness Behavior (AIB) cluster (23.3%) and somatization cluster (23.3%). Fifteen patients met the criteria for an ICD diagnosis. Among patients without an ICD-10 diagnosis, 77.8% had at least one DCPR syndrome (p < 0.05). Higher scores on ESAS symptoms (i.e., tiredness, nausea, depression, anxiety, feeling of a lack of well-being and distress), ESAS-Physical, ESAS-Psychological, and ESAS-Total were found among DCPR cases than DCPR non-cases. In conclusion, a high prevalence of DCPR diagnoses was found in WKTs, including those who resulted to be ICD-10 non-cases. The joint use of DCPR and other screening tools (e.g., ESAS) should be evaluated in future research as part of a correct psychosocial assessment of WKTs. Full article
(This article belongs to the Special Issue Mental Health and Transplantation: Challenges and Solutions)

Review

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14 pages, 16534 KiB  
Review
Mental Health and Well-Being of Solid Organ Transplant Donors. The Forgotten Sacrifices
by Xin-Hui Pan, Jonathan Zhi Kai Toh, Cheng Han Ng, Phoebe Wen Lin Tay, Neng Wei Wong, Alfred Wei Chieh Kow, Anantharaman Vathsala, Eunice Xiang-Xuan Tan, Mark Dhinesh Muthiah and Wen Hui Lim
Transplantology 2021, 2(3), 274-287; https://doi.org/10.3390/transplantology2030026 - 19 Jul 2021
Cited by 2 | Viewed by 12536
Abstract
In light of a global organ shortage, living donor transplantation has become increasingly relevant as an alternative to deceased donor transplantation. While current research has revolved around the medical aspects of transplantation, there remains a paucity of literature regarding the quality of life [...] Read more.
In light of a global organ shortage, living donor transplantation has become increasingly relevant as an alternative to deceased donor transplantation. While current research has revolved around the medical aspects of transplantation, there remains a paucity of literature regarding the quality of life (QOL) of living donors. Hence, this review aims to provide a comprehensive outline of the current landscape of living liver and kidney transplantation, with a focus on the mental health and wellbeing of donors. As highlighted in previous studies, organ donation has a significant impact on both physical and mental aspects of donor wellbeing, with marked deteriorations occurring in the short term. Furthermore, other qualitative aspects such as financial burden contribute greatly to donor distress, reflecting a need for improved donor care. To address these pertinent issues, recommendations for a successful transplant program are detailed in this review, which encompasses psychological and social aspects of donor care throughout the donation process. Further research can be done on the impact of recipient deaths on donor QOL and appropriate interventions. Overall, given the selfless sacrifices of living donors, the care of their mental wellbeing is essential. Therefore, greater emphasis should be placed on the provision of adequate psychosocial support for them. Full article
(This article belongs to the Special Issue Mental Health and Transplantation: Challenges and Solutions)
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