Outcomes of Renal Transplantation in Patients With Bipolar Affective Disorder and Schizophrenia: A National Retrospective Cohort Study
Outcomes of Renal Transplantation in Patients With Bipolar Affective Disorder and Schizophrenia: A National Retrospective Cohort Study
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DOI：
10.1016/j.psym.2016.08.010
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发表时间：
2017-01-01
期刊：
影响因子：
3.4
通讯作者：
Conlon, Peter
中科院分区：
文献类型：
--
作者：
Butler, Mary I.;McCartan, Deirdre;Conlon, Peter
背景：患有严重精神疾病的患者，如精神分裂症和双相情感障碍（BPAD），过去曾因其精神疾病而被排除在器官移植计划之外。然而，关于这些患者的肾移植结果的数据很少，也没有证据支持这种排除。方法：我们回顾了爱尔兰国家肾移植计划的数据库，并确定了所有有BPAD或精神分裂症病史且在28年内接受过移植的患者，收集了以下结果的数据：患者生存、移植物存活、移植物功能、移植住院时间和急性排斥发作频率。对照组为一般移植组，即所有在相关时间段内无上述精神障碍且接受过肾移植的患者。结果：1986年1月1日至2013年12月31日，我中心共进行肾移植3000例。在移植受者中，0.5% （n = 15）被诊断为BP AD， 0.2% （n = 6）患有精神分裂症。BPAD或精神分裂症组与普通肾移植组在患者生存、移植物生存和移植物功能方面无显著差异。此外，移植住院时间和急性排斥发作频率在三组之间具有可比性。结论：尽管考虑精神合并症是移植前评估和选择的重要组成部分，但患者不应因BPAD或精神分裂症的诊断而受到歧视，因为没有证据表明这会对移植结果产生负面影响。
Background: Patients with severe psychiatric disorders such as schizophrenia and bipolar affective disorder (BPAD) have in the past been excluded from organ transplantation programs based on their psychiatric illness. However, there is little data on the outcomes of renal transplantation in these patients and little evidence to support such exclusion. Methods: We reviewed the database of the Irish National Renal Transplant Programme and identified all patients with a history of BPAD or schizophrenia who had received a transplant over a 28-year period Data were collected for the following outcomes: patient survival, graft survival, graft function, length of hospitalization for transplantation, and frequency of acute rejection episodes. The control group was the general transplant group, that is, all patients without these psychiatric disorders and who had received a renal transplant during the relevant time period Results: Between January 1, 1986, and December 31, 2013, 3000 renal transplants were performed at our center. Of the transplant recipients, 0.5% (n = 15) had a diagnosis of BP AD and 0.2% (n = 6) had schizophrenia. No significant differences were found between the BPAD or schizophrenia group and the general renal transplant group in relation to patient survival, graft survival, and graft function. In addition, length of hospital admission for transplantation and frequency of acute rejection episodes were comparable among the 3 groups. Conclusions: Although consideration of psychiatric comorbidity is an important part of pre-transplant assessment and selection, patients should not be discriminated against based on a diagnosis of BPAD or schizophrenia as there is no evidence that this negatively affects transplant outcomes.