Impact of psychotic disorder on transplant eligibility and outcomes

Abstract

Purpose of review: Organ transplantation decisions are complex, and psychosocial assessment is an important part of the process. The impact of pretransplant psychotic disorder on posttransplant outcomes is unclear, but some guidelines cite psychosis as a relative contraindication to organ transplantation because of concerns about medication adherence and poor postoperative outcomes. This review explores the evidence for poorer solid organ transplant outcomes for people with preexisting psychotic disorders and discusses future directions for how research can contribute to a better understanding of how organ transplantation outcomes are affected by psychotic illness.

Recent findings: When added to the existing small body of literature, recent findings show a continuing insufficient evidence base to suggest that the presence of psychotic disorder increases risk of poorer adherence and outcomes. The evidence points to social isolation being a key factor in poorer adherence posttransplant.

Summary: Further research is needed to determine the impact of psychotic disorder on transplant outcomes, but based on current evidence a diagnosis of psychotic disorder should not preclude consideration for organ transplantation.