| Can Pre-Transplant Psychometric Testing Predict Tacrolimus Intrapatient Variability After Living Kidney Transplantation? |
Ah Rah Lee1 
, Sang Min Lee1
, Won Sub Kang1
, Ah Rang Cho2
, Jong Woo Kim1
, Jin Kyung Park2
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1Department of Psychiatry, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
2Department of Psychiatry, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea |
Correspondence: Jin Kyung Park ,Tel: +82-2-440-6175, Email: parkdawit@khu.ac.kr
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Received: February 20, 2024 Revised: April 12, 2024 Accepted: April 24, 2024 Published online: July 24, 2024 |
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| Abstract |
Objective
Tacrolimus intrapatient variability (Tac IPV) has been considered a marker for post-graft risk. We investigated pre-transplant psychometric testing to predict Tac IPV after living kidney transplantation.
Methods
Minnesota Multiphasic Personality Inventory-2 (MMPI-2) examined during pre-transplant evaluation by 102 recipients were analyzed. Subjects were divided into two groups, low IPV (L-IPV) and high IPV (H-IPV), by cutoffs of Tac IPV: median of 24 and value of 30. T-scores of MMPI-2 scales were used to analyze difference between L-IPV and H-IPV using independent t-tests. Stepwise multiple logistic regression was used to test whether MMPI-2 scales affected Tac IPV. Confusion matrix of logistic regression was used to explain statistical power. Cutoff values of significant scales for H-IPV were analyzed by constructing receiver operating characteristic curves.
Results
Hysteria (Hy) and depression (D) scale scores and Tac IPV were associated in IPV 24 (odds ratio [OR]: 1.08, p<0.01 for Hy; OR: 0.93, p<0.01 for D) and IPV 30 models (OR: 1.09, p<0.01 for Hy; OR: 0.92, p<0.01 for D). Paranoia (Pa) scale scores were associated with Tac IPV in IPV 24 model (OR=1.10, p<0.01) and were significantly higher in H-IPV 24 (p<0.01). F1 scores of confusion matrix in IPV 24 and 30 models were 0.70 and 0.71, respectively. Cutoffs of Hy, D, and Pa scales were 51, 57, and 47, respectively.
Conclusion
MMPI-2 profile is suggested as a predictor for high Tac IPV after living kidney transplantation. |
| Key words
Kidney transplantation; Recipients; Minnesota Multiphasic Personality Inventory-2; Tacrolimus; Intrapatient variability |
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