Assessing clinical outcome of transplant patients by means of the INTERMED

Aim: The objective of this ongoing multicentric study is to evaluate if the INTERMED (IM), a screening instrument to assess case complexity, identifies patients at risk for unfavourable postoperative development. Methods: So far, 217 kidney (KTX) and liver (LTX) transplant patients were evaluated preoperatively and 70 of them at 12 months post transplant. Biopsychosocial profiles were assessed using the IM. Quality of life [Short Form 36 (SF-36)] and depressive symptomatology (HADS) were measured before transplant (TX) and 1 year after transplantation. Correlations between the IM scores pre transplant and SF-36 and HADS scores at follow-up were studied after controlling for baseline measures. Results: At baseline, LTX scored higher on the depression subscale, the sum-score of the HADS (P b.001, Mliver/kidney depression 7.81/6.08, Mliver/kidney sum-score 15.1/12.3) and lower on the SF-36 physical-health scale (Mliver/kidney 36.0/42.3). For the whole sample, we could not state a significant relationship between the IM sum-score before TX and SF-36 and HADS measures after TX, but we found a negative correlation between the IM psychological domain and the SF-36 subscale vitality (r=0.37) and mental health scale (r=0.50). For KTX, a negative correlation was found between the IM sum-score 1, the biological 2, and the psychological domain and the SF-36 scale physical functioning (r1=0.56, r2=0.46, r3=0.57). For LTX, a negative correlation (r=0.38) emerged for the IM psychological domain and the SF-36 subscale vitality. Discussion: This preliminary analysis demonstrates a certain predictive quality of the IM, indicating an association of higher IM scores with an increased risk for poor health-related quality of life after TX. We plan to present an elaborated analysis of our findings at the conference.