An Innovative Approach to Assessing the Psychosocial Impacts on Liver Transplant Recipients: The Prediction-by-correspondence Analysis

Abstract

Background

Innovative analytic techniques are applied to the psychological functioning of liver transplant (LT) recipients to comprehend its effect on post-transplant survival, hypothesizing that adherence will be predicted by psychosocial functioning.

Methods

The psychosocial functioning of 248 LT recipients (88 females) aged 19 to 74 is assessed using the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT). In addition, the Medication Level Variability Index (MLVI) and biopsy-proven rejection are utilized to evaluate successful adherence. The Z-scores of the SIPAT scores are used to transform them into an ordinal variable with excellent, good, minimally acceptable, and poor categories. We employ a modified version of correspondence analysis to predict the binary MLVI and rejection, which signify either success or failure in adherence, using ordinal MLVI categories as predictors.

Results

The excellent SIPAT category for LT beneficiaries was strongly related to adherence, whereas the minimally acceptable SIPAT was strongly related with failure in adherence. Females, ages 19–50, and ages 67–74 were associated with adherence (r = 0.49–1.00), whereas males and ages 56–60 were associated with failure in adherence (r = 0.43–0.91)

Conclusion

The clinical implications and utility of the novel analytic approaches introduced in the study are discussed.