Development of A Protocol for Pre-Transplantation Psychiatric and Psychological Evaluation of Living Donors and Recipients

Background: A pre-surgical psychiatric and psychological evaluation is necessary to determine the donors' and recipients' health for the transplantation procedure. Psychological issues may contribute to the need for a liver transplant in the first place, such as alcoholism-related liver dysfunction, which can result in negative outcomes if left unaddressed. Objective: This study aimed to assess the utility of a unified pre transplantation psychiatric and psychological evaluation protocol for living donors and recipients. The other objective was to understand the noticed psychological impairment in patients following this evaluation and provide individualized strategies for managing any challenges. Methods: The protocol design was completed in 3 stages. The first step involved determining the assessment aspects and reviewing prior related research. A team of health professionals was engaged in selecting suitable standardized measures and employing them. Results: Nine living donors and eight recipients were assessed during the study period from September 2023 to January 2024 at Manipal Hospital, Bangalore, India. For 16 out of 17 patients, adequate psychological evaluation outcomes were concluded in the medical record. The total survival rate for donors was 100% and 87.5% for recipients. Conclusion: The post-transplant outcomes of the protocol aligned with the pre-transplant assessment of the donors and recipients through a one-month post-surgery follow-up, with higher psychosocial scores reflecting faster recovery and better adherence in the patients. There was no discernible variation in the rejection rates between the psychosocial patients with lower scores and those with higher adequate scores.