History of psychosis and mania, and outcomes after kidney transplantation - a retrospective study

M.Z. Molnar; J.D. Eason; A. Gaipov; M. Talwar; P.K. Potukuchi; K. Joglekar; A. Remport; Z. Mathe; I. Mucsi; M. Novak; K. Kalantar-Zadeh; C.P. Kovesdy

doi:10.1111/tri.13127

History of psychosis and mania, and outcomes after kidney transplantation - a retrospective study

M.Z. Molnar, J.D. Eason, A. Gaipov, M. Talwar, P.K. Potukuchi, K. Joglekar, A. Remport, Z. Mathe, I. Mucsi, M. Novak, K. Kalantar-Zadeh, C.P. Kovesdy

School of Medicine

Research output: Contribution to journal › Article

5 Citations (Scopus)

Abstract

History of psychosis or mania, if uncontrolled, both represent relative contraindications for kidney transplantation. We examined 3680 US veterans who underwent kidney transplantation. The diagnosis of history of psychosis/mania was based on a validated algorithm. Measured confounders were used to create a propensity score-matched cohort (n = 442). Associations between pretransplantation psychosis/mania and death with functioning graft, all-cause death, graft loss, and rejection were examined in survival models and logistic regression models. Post-transplant medication nonadherence was assessed using proportion of days covered (PDC) for tacrolimus and mycophenolic acid in both groups. The mean ± SD age of the cohort at baseline was 61 ± 11 years, 92% were male, and 66% and 27% of patients were white and African-American, respectively. Compared to patients without history of psychosis/mania, patients with a history of psychosis/mania had similar risk of death with functioning graft [subhazard ratio (SHR) (95% confidence interval (CI)): 0.94(0.42–2.09)], all-cause death [hazard ratio (95% CI): 1.04 (0.51–2.14)], graft loss [SHR (95% CI): 1.07 (0.45–2.57)], and rejection [odds ratio(95% CI): 1.23(0.60–2.53)]. Moreover, there was no difference in immunosuppressive drug PDC in patients with and without history of psychosis/mania (PDC: 76 ± 21% vs. 78 ± 19%, P = 0.529 for tacrolimus; PDC: 78 ± 17% vs. 79 ± 18%, P = 0.666 for mycophenolic acid). After careful selection, pretransplantation psychosis/mania is not associated with adverse outcomes in kidney transplant recipients. © 2018 Steunstichting ESOT

Original language	English
Pages (from-to)	554-565
Number of pages	12
Journal	Transplant International
Volume	31
Issue number	5
DOIs	https://doi.org/10.1111/tri.13127
Publication status	Published - 2018

Keywords

mycophenolic acid
tacrolimus, adult
African American
age distribution
all cause mortality
Article
Caucasian
controlled study
disease association
female
graft failure
graft rejection
human
kidney transplantation
major clinical study
male
mania
medication compliance
priority journal
psychosis
risk assessment
risk factor
sex difference
treatment outcome
veteran
aged
bipolar disorder
cause of death
complication
middle aged
mortality
retrospective study, Aged
Bipolar Disorder
Cause of Death
Female
Graft Rejection
Humans
Kidney Transplantation
Male
Medication Adherence
Middle Aged
Psychotic Disorders
Retrospective Studies

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10.1111/tri.13127

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85045516722&doi=10.1111%2ftri.13127&partnerID=40&md5=67326f4f9bbabd989fc260122aabed06

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Molnar, M. Z., Eason, J. D., Gaipov, A., Talwar, M., Potukuchi, P. K., Joglekar, K., Remport, A., Mathe, Z., Mucsi, I., Novak, M., Kalantar-Zadeh, K., & Kovesdy, C. P. (2018). History of psychosis and mania, and outcomes after kidney transplantation - a retrospective study. Transplant International, 31(5), 554-565. https://doi.org/10.1111/tri.13127

History of psychosis and mania, and outcomes after kidney transplantation - a retrospective study. / Molnar, M.Z.; Eason, J.D.; Gaipov, A.; Talwar, M.; Potukuchi, P.K.; Joglekar, K.; Remport, A.; Mathe, Z.; Mucsi, I.; Novak, M.; Kalantar-Zadeh, K.; Kovesdy, C.P.

In: Transplant International, Vol. 31, No. 5, 2018, p. 554-565.

Research output: Contribution to journal › Article

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title = "History of psychosis and mania, and outcomes after kidney transplantation - a retrospective study",

abstract = "History of psychosis or mania, if uncontrolled, both represent relative contraindications for kidney transplantation. We examined 3680 US veterans who underwent kidney transplantation. The diagnosis of history of psychosis/mania was based on a validated algorithm. Measured confounders were used to create a propensity score-matched cohort (n = 442). Associations between pretransplantation psychosis/mania and death with functioning graft, all-cause death, graft loss, and rejection were examined in survival models and logistic regression models. Post-transplant medication nonadherence was assessed using proportion of days covered (PDC) for tacrolimus and mycophenolic acid in both groups. The mean ± SD age of the cohort at baseline was 61 ± 11 years, 92% were male, and 66% and 27% of patients were white and African-American, respectively. Compared to patients without history of psychosis/mania, patients with a history of psychosis/mania had similar risk of death with functioning graft [subhazard ratio (SHR) (95% confidence interval (CI)): 0.94(0.42–2.09)], all-cause death [hazard ratio (95% CI): 1.04 (0.51–2.14)], graft loss [SHR (95% CI): 1.07 (0.45–2.57)], and rejection [odds ratio(95% CI): 1.23(0.60–2.53)]. Moreover, there was no difference in immunosuppressive drug PDC in patients with and without history of psychosis/mania (PDC: 76 ± 21% vs. 78 ± 19%, P = 0.529 for tacrolimus; PDC: 78 ± 17% vs. 79 ± 18%, P = 0.666 for mycophenolic acid). After careful selection, pretransplantation psychosis/mania is not associated with adverse outcomes in kidney transplant recipients. {\textcopyright} 2018 Steunstichting ESOT",

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AU - Joglekar, K.

AU - Remport, A.

AU - Mathe, Z.

AU - Mucsi, I.

AU - Novak, M.

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AB - History of psychosis or mania, if uncontrolled, both represent relative contraindications for kidney transplantation. We examined 3680 US veterans who underwent kidney transplantation. The diagnosis of history of psychosis/mania was based on a validated algorithm. Measured confounders were used to create a propensity score-matched cohort (n = 442). Associations between pretransplantation psychosis/mania and death with functioning graft, all-cause death, graft loss, and rejection were examined in survival models and logistic regression models. Post-transplant medication nonadherence was assessed using proportion of days covered (PDC) for tacrolimus and mycophenolic acid in both groups. The mean ± SD age of the cohort at baseline was 61 ± 11 years, 92% were male, and 66% and 27% of patients were white and African-American, respectively. Compared to patients without history of psychosis/mania, patients with a history of psychosis/mania had similar risk of death with functioning graft [subhazard ratio (SHR) (95% confidence interval (CI)): 0.94(0.42–2.09)], all-cause death [hazard ratio (95% CI): 1.04 (0.51–2.14)], graft loss [SHR (95% CI): 1.07 (0.45–2.57)], and rejection [odds ratio(95% CI): 1.23(0.60–2.53)]. Moreover, there was no difference in immunosuppressive drug PDC in patients with and without history of psychosis/mania (PDC: 76 ± 21% vs. 78 ± 19%, P = 0.529 for tacrolimus; PDC: 78 ± 17% vs. 79 ± 18%, P = 0.666 for mycophenolic acid). After careful selection, pretransplantation psychosis/mania is not associated with adverse outcomes in kidney transplant recipients. © 2018 Steunstichting ESOT

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