Psychosocial vulnerability predicts psychosocial outcome after an organ transplant: results of a prospective study with lung, liver, and bone-marrow patients.

Objective: The pretransplant medical evaluation of transplantation candidates includes an assessment of psychosocial data. This study investigates psychosocial vulnerability as a predictor of posttransplant outcome.

Methods: Seventy-six patients were assessed prior to lung, liver, or bone-marrow transplant. Pretransplant vulnerability markers were cognitive beliefs (sense of coherence and optimism), affect (anxiety and depression), and external resources (social support). In addition, psychosocial functioning was assessed by professionals. Quality of life, general life satisfaction, need for counseling, and survival rate were assessed 12 months after transplant.

Results: Pretransplant variables explain 21-40% of the variance in posttransplant psychosocial outcome variables. Cognitive beliefs predict mental quality of life; affect (depression) and social support predict life satisfaction; and expert-rated psychosocial functioning predicts life satisfaction and need for counseling.

Conclusion: The multidimensional vulnerability model is suitable for predicting posttransplant psychosocial outcome. Patients with high pretransplant vulnerability should receive ongoing psychosocial counseling.