Psychological characteristics of candidates for liver transplantation: Differences according to history of substance abuse and UNOS listing

Liver transplantation for patients with a history of substance abuse remain s controversial. Resumption of heavy alcohol use postoperatively is a threa t to long-term survival, but recidivism among transplanted alcoholics is re portedly low. An argument against psychological evaluation prior to transpl antation revolves around the speculation that candidates will attempt to po rtray themselves as more desirable prior to listing with UNOS (United Netwo rk for Organ Sharing). This study measured psychological distress. coping s tyles, optimism, selected personality features, and perception of family en vironment among 73 U.S. military veterans who were candidates for liver tra nsplantation. Candidates with positive histories of substance abuse reveale d significantly more distress, less adaptive coping styles, and more charac ter pathology than their counterparts. The only significant difference acco rding to UNOS listing was on one measure of family environment. Results sup port preoperative psychological assessment and intervention on a more exten sive level for substance abusers and raise questions for future research. ( C) 1999 John Wiley & Sons. Inc.