Psicologia dei trapianti Analisi dei profili di personalità dei riceventi il trapianto renale da donatore cadavere e da donatore vivente: studio pre e post trapianto.

Introduction: Renal transplantation is the best therapeutic treatment for end-stage chronic renal disease. The aim of the study is to verify the impact of transplantation on psychological dimensions and quality of life in recipients before and after surgery. Materials and methods: 63 patients were enrolled from January 2023 to July 2024 at the UOC of Organ Transplant Surgery in collaboration with the Regional Transplant Centre of ASL 1 Abruzzo. The first evaluation time was on the day of transplantation, the second time at 30 days after transplantation. It should be noted that transplant patients were assessed for psychological suitability before the transplantation. The questionnaires used were the SCL90R and the SF36 accompanied by a clinical psychological interview. The Shapiro-Wilk test was used to assess the normality of the distribution of the continuous variables, and depending on the result, Student's t-test for paired samples or Wilcoxon's test were used to compare the means of the continuous variables before and after transplantation. Any associations between the continuous variables were explored by Spearman correlation. Results: Regarding the comparison between before and after transplantation for the scales Positive Symptom Total -PST and Depression-DEP the mean score in the second assessment was lower than in the first. The mean score in the second assessment of the General Health scale was higher than in the first assessment. The mean score in the second assessment of the Pain scale was lower than in the first. With regard to the association analysis, before transplantation it was found that Somatisation-SOM showed a strong negative association with Mental Health, Physical Activity, Physical Pain and Emotional Limitation. Interpersonal Hypersensitivity-IS showed a negative association with Mental Health. Depression-DEP showed a positive association with Sleep-SLEEP and a negative association with Vitality, Mental Health and Mental Health Index-ISM. Anxiety-ANX showed a negative association with Mental Health. Phobic Anxiety-PHOB showed a negative association with General Health, Vitality and Social Activities. Post-transplant Somatisation-SOM showed a negative association with Physical Limitation, Physical Pain, General Health, Vitality, Emotional Limitation, Physical Health Index-ISF and Mental Health Index-ISM. Anxiety-ANX showed a negative association with General Health, Social Activities, Emotional Limitation, Mental Health and Mental Health Index-ISM. Sleep-SLEEP showed a negative association with General Health, Vitality, Social Activities, Emotional limitation, and Mental Health-ISM Index. Discussion: Comparison between before and after transplantation shows that there is a positive variation related to the lower perception of psychosomatic symptoms after transplantation. The Depression scale also deflects. The General Health dimension reports a significant improvement post-transplantation. The presence of anxious aspects is found throughout the transplantation process. Interesting associations emerge with respect to sleep quality, whose association before transplantation with mental health is negative with moderate strength. After transplantation there are negative associations with General health and Vitality. Conclusions: The transplantation process examines variation in some dimensions (DEP, ANX, SLEEP, QoL) from before to after transplantation, hypothesising how this moment-event elicits a mental as well as physical change already in a short time. It has been established how assessing patients before transplantation provides indications on the evolution of psychological dimensions after transplantation itself. This will make it possible to structure a psychological pathway tailored to the needs of each patient.