Survival of 247 liver transplant candidates: Relationship to pretransplant psychiatric variables and presence of delirium

We retrospectively gathered survival data for a cohort of previously published, prospectively studied liver transplantation candidates. Of the 247 candidates in the original cohort, 130 were transplanted at our hospital. The 117 who were not transplanted were older, had significantly more cognitive impairment on Trailmaking Tests and slowing on electroencephalogram (EEG), and had more delirium (25% vs 15%); they also had significantly more impairment in family relationships prior to transplant. Of the 130 patients who were transplanted, 91 survived as of December 1989 and 39 did not. None of the cognitive, EEG, or serum albumin results differentiated these groups, nor did age or incidence of pretransplant delirium (21% of those who died vs 12% of survivors). However, the highest level of adaptive functioning in the year prior to candidacy evaluation was significantly better in survivors; and there was more family and social dysfunction in nonsurvivors. Though the nonsurvivors received significantly more livers, histocompatibility did not distinguish the groups. The presence or absence of delirium did not predict survival status or duration for the whole group of transplanted patients. However, for the subgroup of transplant survivors, delirious patients had significantly shorter waits for transplantation and longer survival times than nondelirious ones.