Outcomes of Renal Transplantation in Patients With Bipolar Affective Disorder and Schizophrenia: A National Retrospective Cohort Study.

Background: Patients with severe psychiatric disorders such as schizophrenia and bipolar affective disorder (BPAD) have in the past been excluded from organ transplantation programs based on their psychiatric illness. However, there is little data on the outcomes of renal transplantation in these patients and little evidence to support such exclusion.

Methods: We reviewed the database of the Irish National Renal Transplant Programme and identified all patients with a history of BPAD or schizophrenia who had received a transplant over a 28-year period. Data were collected for the following outcomes: patient survival, graft survival, graft function, length of hospitalization for transplantation, and frequency of acute rejection episodes. The control group was the general transplant group, that is, all patients without these psychiatric disorders and who had received a renal transplant during the relevant time period.

Results: Between January 1, 1986, and December 31, 2013, 3000 renal transplants were performed at our center. Of the transplant recipients, 0.5% (n = 15) had a diagnosis of BPAD and 0.2% (n = 6) had schizophrenia. No significant differences were found between the BPAD or schizophrenia group and the general renal transplant group in relation to patient survival, graft survival, and graft function. In addition, length of hospital admission for transplantation and frequency of acute rejection episodes were comparable among the 3 groups.

Conclusions: Although consideration of psychiatric comorbidity is an important part of pretransplant assessment and selection, patients should not be discriminated against based on a diagnosis of BPAD or schizophrenia as there is no evidence that this negatively affects transplant outcomes.