Is kidney transplantation safe after careful selection of the recipients with a history of psychotic disorder?

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Is kidney transplantation safe after careful selection of the recipients with a history of psychotic disorder?

Transpl Int. 2017 Oct 11;:

Authors: Molnar MZ

Abstract
The prevalence of both bipolar disorder and schizophrenia is around 1-4% in the general population and represents a relative contraindication for kidney transplantation. There are several reasons for this, including concerns in relation to relapse of psychiatric illness, medication and other post-transplant treatment non-adherence, inadequate social support, emotional and cognitive capability, and potential drug interactions between psychotropic and immunosuppressant medications. Only a small proportion of recipients with psychotic disorder has eventually been transplanted. Almost half of these recipients will have psychotic relapses after transplantation and these relapses illustrate a strong association with graft loss and death. The published data on post-transplant outcomes in patients with pre-transplant psychotic disorders are extremely limited. However, the emerging data suggests that after careful recipient selection and a very close follow-up after transplantation, recipients with history of bipolar disorder and schizophrenia have similar patient and graft survival when compared to recipients without psychotic disorders. Further data are urgently needed to confirm these mainly retrospective results from small studies. This article is protected by copyright. All rights reserved.

PMID: 29024009 [PubMed - as supplied by publisher]