Review: outcomes of transplant candidates with psychotic disorders.

IF 1.9 4区医学 Q3 TRANSPLANTATION

Current Opinion in Organ Transplantation Pub Date : 2025-09-25 DOI:10.1097/MOT.0000000000001251

Kathy L Coffman

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引用次数: 0

Abstract

Purpose of review: Transplantation in candidates with psychotic disorders has been a controversial topic for over 40 years. Reviewing the outcomes of these candidates may inform decisions going forward, though it is unclear whether outcomes with kidney recipients is generalizable to other organs, which are life-sparing not mainly life-enhancing.

Recent findings: Outcomes in recipients with psychotic disorders after kidney transplants were described in three studies. Outcomes with heart, lung, pancreas, and small bowel or multivisceral transplants is sparse to nonexistent. There were 26 cases and 8 case series published, mostly highly selected patients, with small sample size, and the majority had less than 3-year follow-up. Guidelines were proposed for this population based on a survey of 12 centers.

Summary: More systematic study is needed on the risks and barriers to transplantation in these candidates. More data is needed regarding outcomes in those recipients with life-sparing transplants for whom there is not a rescue plan in case the graft is lost. Candidates should be evaluated on an individual basis based on known risk factors in accordance with the ethical principles of beneficence, justice, and utility in the face of scarce resources.

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回顾：有精神障碍的移植候选人的结局。

回顾目的：40多年来，精神障碍患者的移植一直是一个有争议的话题。虽然尚不清楚肾脏受体的结果是否可以推广到其他器官，但回顾这些候选结果可能会为下一步的决定提供信息，这些器官主要是挽救生命而不是提高生命。最近的发现：三个研究描述了肾移植后精神障碍受者的结局。心脏、肺、胰腺、小肠或多脏器移植的结果很少甚至不存在。已发表病例26例，病例系列8个，多为高选择性患者，样本量小，多数随访时间小于3年。根据对12个中心的调查，提出了针对这一人群的指导方针。总结：需要对这些候选者进行移植的风险和障碍进行更系统的研究。对于那些接受挽救生命的移植的受者，如果移植物丢失，没有救援计划，他们的结果需要更多的数据。在面对稀缺资源的情况下，应根据仁慈、公正和实用的道德原则，根据已知的风险因素对候选人进行个人评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Organ Transplantation 医学-移植

CiteScore

4.10

自引率

4.50%

发文量

124

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.