Are changes in the clinical and laboratory parameters of patients on the liver transplant waiting list predictive factors for worsening quality of life, anxiety, and depression scores?

• Grant number: 25/04727-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: June 01, 2025
• End date: May 31, 2026
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Érika Bevilaqua Rangel
• Grantee: Guilherme de Oliveira Vitiello
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Advanced liver diseases represent a significant challenge to global public health, accounting for approximately 2 million deaths annually. In advanced stages, these pathologies irreversibly compromise liver function, making liver transplantation the only therapeutic alternative capable of prolonging patients' survival. Prioritization on the transplant waiting list is currently based on the Model for End-Stage Liver Disease (MELD), a score calculated from serum levels of bilirubin, creatinine, and INR, aiming to estimate the risk of mortality due to liver failure.Previous studies indicate that high MELD scores are associated with decreased quality of life and increased levels of anxiety and depression among patients on the waiting list. However, these investigations are scarce and present methodological limitations that hinder a comprehensive understanding of the psychosocial impact of liver disease.Given this, the present study proposes a multidimensional approach, including, in addition to MELD, other laboratory parameters such as complete blood count, urea, albumin, and electrolytes, with the objective of elucidating the correlations between advanced liver diseases and their psychosocial effects on patients awaiting liver transplantation.It is expected that there will be a negative correlation between MELD and quality of life scores, as well as a positive correlation between MELD and levels of anxiety and depression. Similarly, it is hypothesized that significant changes in other laboratory biomarkers may reflect comparable psychosocial impacts.Based on these findings, the study aims to improve pre-transplant therapeutic approaches through the implementation of early interventions, such as psychological and psychiatric support, along with more comprehensive outpatient monitoring. Moreover, this study may contribute to the inclusion of psychosocial factors in liver transplant prioritization criteria and encourage further research focused on evaluating the progression of these parameters after surgery. (AU)