bachelorThesis
Intervenciones y desenlaces clínicos en pacientes excluidos de la evaluación pre-trasplante hepático en un centro de referencia
Autor
Gutiérrez Morantes, Hilda Margarita
Amaya Pérez, María Alejandra
Institución
Resumen
INTRODUCTION: Liver transplantation is the best treatment option for patients with end-stage liver disease of any etiology. The success of the clinical intervention depends on the proper selection of the donor and the recipient. Biopsychosocial determinants influence the rate of post-transplant complications and mortality. OBJECTIVE: To identify interventions and clinical outcomes in patients excluded from pre- liver transplant evaluation with a clinical indication for liver transplantation between January 2019 and December 2021 in a single-center experience in Bogotá. METHODS: A cross-sectional study of patients >18 years old with a clinical indication for liver transplantation that were not suitable during the social work and psychology assessment for pre-liver transplant evaluation between January 2019 to December 2021. RESULTS: Between January 2019 to December 2022, 565 patients were considered candidates for pre-liver transplant evaluation. Of these 122 patients were included in our study because they were excluded from evaluation by psychology and social work. 58.2% (n=71) were men, 77% (n=94) belonged to the private health system, 38.5% (n=47) had primary education level, 34.4% (n=42) were unemployed, and the median monthly income was $250 USD (IQR 200 - 487 USD). 32.5% (n=37) become included in the pre-liver transplant study after some intervention. The activation of the extended family network showed a statistically significant difference in its frequency between the groups included and those not included in the pre-transplant study (p=0.011). CONCLUSION: Interventions by the multidisciplinary liver transplantation support group allow access to pre-transplant evaluation, admission to the waiting list, and transplantation to patients initially excluded for different reasons that can be modified with these tools.