Pre-Transplant Depression Is Associated with Length of Hospitalization, Discharge Disposition, and Survival after Liver Transplantation
Open accessAbstract
Depression after liver transplantation has been associated with decreased survival, but the effects of pre-transplant depression on early and late post-transplant outcomes remain incompletely evaluated. We assessed all patients who had undergone single-organ liver transplantation at a single center over the prior 10 years. A diagnosis of pre-transplant depression, covariates, and the outcomes of interest were extracted from the electronic medical record. Potential covariates included demographics, etiology and severity of liver disease, comorbidities, donor age, graft type, immunosuppression, and ischemic times. In multivariable models adjusting for these factors, we evaluated the effect of pre-transplant depression on transplant length of stay (LOS), discharge disposition (home vs. facility) and long-term survival. Among 1115 transplant recipients with a median follow-up time of 5 years, the average age was 56±11 and MELD was 12±9. Nineteen percent of the study population had a history of pre-transplant depression. Pre-transplant depression was associated with longer LOS (median = 19 vs. 14 days, IRR = 1.25, CI = 1.13,1.39), discharge to a facility (36% vs. 25%, OR 1.70,CI = 1.18,2.45), and decreased survival (HR = 1.54,CI = 1.14,2.08) in this cohort, accounting for other potential confounders. In conclusion, pre-transplant depression was significantly associated with longer transplant length of stay, discharge to a facility, and mortality in this cohort.
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Depression is known to be more strongly associated with reduced quality of life than to liver disease severity.
“Depression is known to be more strongly associated with reduced QOL than to liver disease severity.31”
From A Behavioral Health Program for Alcohol Use Disorder, Substance Abuse, and Depression in Chronic Liver Disease (2019) · cites this paper as [31]
The Introduction says depression detracts from quality of life, and Table 1 (Results, Patient Population) shows similar mean MELD scores in recipients with and without pre-transplant depression. The paper does not compare the strength of depression’s association with quality of life against its association with liver disease severity; quality of life was not measured in that comparison. Page numbers are unavailable in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredPretransplant depression was associated with post-transplant survival rates, length of hospitalization, and discharge to an outside facility.
“Further, pretransplant DEP was also associated with post-transplant survival rates, length of hospitalization, and discharge to an outside facility.[8]”
From Prevalence of depression and anxiety symptoms by liver disease etiology (2023) · cites this paper as [8]
Rogal and colleagues reported the prevalence of ICD-9 depression diagnoses to be 22% in patients with alcohol-associated liver disease before liver transplant.
“Rogal and colleagues reported the prevalence of ICD-9 DEP diagnoses to be 22% in patients with alcohol-associated liver disease (ALD) before liver transplant.”
From Prevalence of depression and anxiety symptoms by liver disease etiology (2023) · cites this paper as [8]
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- Authors
- Rogal, S. S., Mankaney, G., Udawatta, V., Chinman, M., Good, C. B., Zickmund, S., Bielefeldt, K., Chidi, A., Jonassaint, N., Jazwinski, A., Shaikh, O., Hughes, C., Fontes, P., Humar, A., & DiMartini, A.
- Affiliations
- University of Pittsburgh (US)
- RAND Corporation (US)
- Corresponding author
- Rogal, Shari S.
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-11-07
- Volume
- 11
- Issue
- 11
- Pages
- e0165517
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5098732
- OpenAlex
- W2549641975
- Cited by
- 43
- References
- 29
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 6 · 2023: 4 · 2022: 4 · 2021: 4 · 2020: 6 · 2019: 3 · 2018: 6 · 2017: 1
- FWCI
- 3.69
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/publicdomain/zero/1.0/ (vor)
- Locations
- PLoS ONE (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- U.S. Department of Veterans Affairs
- VA Pittsburgh Healthcare System
- Topics
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Health Sciences › Medicine › Transplantation › Organ and Tissue Transplantation Research
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Keywords
- liver transplantation, discharge disposition, post-transplant survival, mortality, psychiatric comorbidity, MELD score
- MeSH terms
- Depression, Female, Humans, Length of Stay, Male, Middle Aged, Patient Discharge, Retrospective Studies, Survival Analysis, Liver Transplantation, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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