Goals of psychosocial screening include careful assessment and identification of potential modifiable factors that can affect successful delivery of care before, during, and after organ transplantation. Evaluation of the patient's comorbid psychiatric conditions, history of alcohol, tobacco, and other substance use, cognitive functioning, motivation, coping skills, and ability to collaborate with the transplant team and adhere to treatment recommendations provides valuable information for treatment planning.
Several screening tools have been introduced over the years in an effort to standardize the assessments, manage candidate selection bias, and establish consistency. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) can be effectively used as a standalone tool or within the context of a comprehensive assessment, with cut-off decision points reflecting the individual center's experience and transplant candidate selection threshold criteria.
Patients with complex chronic medical and comorbid psychiatric conditions represent a challenging group with higher resource utilization, an increased risk of hospital readmission, and challenges with posttransplant treatment adherence. A majority of these patients are seen in the physical outpatient setting with limited or no mental health care availability.
Introduction of an integrated care post-organ-transplantation model with psychosocial assessment of biological, psychological, social, and health system domains can offer unique opportunities to evaluate the individual's vulnerability and provide comprehensive quality care, timely intervention, and value-added integration of medical and mental health services.