title: Report of depressive symptoms on waiting list and mortality after liver and kidney transplantation: a prospective cohort study.
abstract: BACKGROUND
  Little research has explored pre-transplantation psychological factors as predictors of outcome after liver or kidney transplantation. Our objective is to determine whether report of depressive symptoms on waiting list predicts outcome of liver and kidney transplantation.
  
  
  METHODS
  Patients on waiting list for liver or kidney transplantation were classified for report or non-report of depressive symptoms on waiting list. 339 were transplanted 6 months later on average, and followed prospectively. The main outcome measures were graft failure and mortality 18 months post-transplantation.
  
  
  RESULTS
  Among the 339 patients, 51.6% reported depressive symptoms on waiting list, 16.5% had a graft failure and 7.4% died post-transplantation.Report of depressive symptoms on waiting list predicted a 3 to 4-fold decreased risk of graft failure and mortality 18-months post-transplantation, independently from age, gender, current cigarette smoking, anxiety symptoms, main primary diagnosis, UNOS score, number of comorbid diagnoses and history of transplantation. Data were consistent for liver and kidney transplantations. Other baseline predictive factors were: for graft failure, the main primary diagnosis and a shorter length since this diagnosis, and for mortality, older age, male gender and the main primary diagnosis.
  
  
  CONCLUSIONS
  Further studies are needed to understand the underlying mechanisms of the association between report of depressive symptoms on waiting list and decreased risk of graft failure and mortality after transplantation.
authors: INSERM U 669, Paris XI University, Psychiatry Department of Bicetre University Hospital, Assistance Publique-Hopitaux de Paris, 94275 Le Kremlin Bicêtre, France.
authors: Emmanuelle
authors: E
authors: Corruble
authors: Caroline
authors: C
authors: Barry
authors: Isabelle
authors: I
authors: Varescon
authors: Antoine
authors: A
authors: Durrbach
authors: Didier
authors: D
authors: Samuel
authors: Philippe
authors: P
authors: Lang
authors: Denis
authors: D
authors: Castaing
authors: Bernard
authors: B
authors: Charpentier
authors: Bruno
authors: B
authors: Falissard
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003863:Depression / Q000401:mortality / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000523:psychology*; D016031:Liver Transplantation / Q000401:mortality / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014850:Waiting Lists / Q000401:mortality*