[Psychosocial screening and selection of candidates for liver transplantation].
281 consecutive candidates for liver transplantation were referred to our consultation-liaison service for psychiatric evaluation over a 4-year period. For these candidates a semistructured psychiatric interview according to the codes listed in the DSM-III-R and the Transplant Evaluation Rating Scale (TERS) classifying patients' level of adjustment in psychosocial functioning were completed. Our study showed a prevalence rate of psychiatric disorders of 65.8 % among candidates. The categories of alcohol abuse (27.8 %) and alcohol dependence (11.7 %) were the most frequent psychiatric diagnoses. The mean TERS summary score of the whole sample was 33.38 +/- 7,31. 68.4 % of the sample were considered good candidates, 18.1 % of the candidates were identified borderline, but acceptable under some conditions, and 13.5 % of the referrals were rated poor liver transplant candidates. The TERS summary scores discriminated well between the three rating categories of candidate quality. Apart from a careful assessment of psychiatric morbidity including substance abuse disorders, the C-L psychiatrist should always rate psychosocial functioning referring to coping, compliance, social support and lifestyle factors among liver transplant candidates. The TERS therefore may be used routinely.
Rothenhäusler
Hans-Bernd
HB
Psychiatrische Klinik und Poliklinik der LMU München, Germany. Hans-Bernd.Rothenhaeusler@klinikum-graz.at
Ehrentraut
Sigrid
S
Kapfhammer
Hans-Peter
HP
D000223:Adaptation, Psychological; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008019:Life Style; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D018579:Patient Selection / Q000941:ethics*; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012919:Social Behavior; D012944:Social Support