Research Article
Psychosocial Status of Liver Transplant Candidates in
Iran and Its Correlation with Health-Related Quality of
Life and Depression and Anxiety
Maryam Banihashemi,
1
Mohsen Hafezi,
1
Mohsen Nasiri-Toosi,
2
Ali Jafarian,
2
Mohammad Reza Abbasi,
3
Mohammad Arbabi,
4
Maryam Abdi,
1
Mahzad Khavarian,
1
and Ali-Akbar Nejatisafa
2,5
1
Psychosomatic Research Center, Tehran University of Medical Sciences, Tehran 1419733141, Iran
2
Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran 1419733141, Iran
3
Nephrology Research Center, Tehran University of Medical Sciences, Tehran 1419733141, Iran
4
Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran 1333715914, Iran
5
Department of Psychiatry, Psychosomatic Research Center, Tehran University of Medical Sciences, Tehran 1419733141, Iran
Correspondence should be addressed to Ali-Akbar Nejatisafa; nejatisafa@tums.ac.ir
Received 24 July 2015; Accepted 14 September 2015
Academic Editor: Patrizia Burra
Copyright © 2015 Maryam Banihashemi et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Objectives. Te study was aimed at providing a psychosocial profle for Iranian liver transplant candidates referred to an established
liver transplantation program. Material and Methods. Patients assessed for liver transplant candidacy in Imam Khomeini Hospital
(Tehran, Iran) between March 2013 and September 2014 were included. Te following battery of tests were administered:
Psychosocial Assessment of Candidates for Transplant (PACT), the Short-Form health survey (SF-36), and Hospital Anxiety and
Depression Scale (HADS). Results. Psychosocial assessment in 205 liver transplant candidates revealed signifcant impairments in
several SF-36 domains; social functioning was the least and physical functioning was the most impaired domains. Te prevalence
of cases with probable anxiety and depressive disorders, according to HADS, was 13.8% and 5.6%, respectively. According to PACT,
24.3% of the assessed individuals were considered good or excellent candidates. In 11.2%, transplantation seemed poor candidate
due to at least one major psychosocial or lifestyle risk factor. Poor candidate quality was associated with impaired health-related
quality of life and higher scores on anxiety and depression scales ( < 0.05). Conclusions. Transplant programs could implement
specifc intervention programs based on normative databases to address the psychosocial issues in patients in order to improve
patient care, quality of life, and transplant outcomes.
1. Introduction
In 2001, End Stage Liver Failure (ESLF) accounted for about
800,000 deaths worldwide [1]. Te 5-year mortality rate
of ESLF is estimated to be 50% [2]. Liver transplantation
is currently the only available treatment that can reverse,
albeit temporarily, the deteriorating trajectory of events
leading to death, thereby signifcantly increasing patient’s life-
expectancy [1].
Te psychiatrist plays a key role in the transplant team;
the services ofered by the psychiatrist span from the initial
stages of the assessment process to the indefnite added life
years gained by the patient afer the transplant [3]. In the
pretransplant period, the psychiatrist evaluates the patient
and forms his/her expert opinion regarding the presence of
absolute contraindications to receiving an organ [4, 5]. Pre-
operatively, adjustment disorders, major depression, anxiety
disorders, and other Axis I disorders are highly prevalent
in transplant candidates. Current substance dependence,
previous deliberate self-harm, and severe mental disorders
are among the contraindications of the organ transplanta-
tion [4]. If psychiatric disorders are lef untreated prior to
Hindawi Publishing Corporation
Journal of Transplantation
Volume 2015, Article ID 329615, 7 pages
http://dx.doi.org/10.1155/2015/329615