Impact of Religious Affiliation on Clinical Outcomes in Liver Transplant Patients

TL;DR

This study found no significant difference in clinical outcomes between liver transplant patients with and without religious affiliation.

Contribution

The study is one of the few to examine the impact of religious affiliation on objective clinical outcomes after liver transplant.

Findings

No significant difference in 30-day readmission rates between religious and non-religious patients.

No significant difference in death or re-transplantation/death outcomes between the groups.

Adjusting for age and hospital admittance status did not change the results.

Abstract

While the impact of spirituality as it relates to quality of life post-liver transplant (LT) has been studied, there are limited data showing how religious affiliation impacts objective measures such as survival. The aim of the study is to investigate whether LT recipients who identified as having a religious affiliation had better clinical outcomes when compared to LT recipients who did not.

Religious affiliation is obtained as part of general demographic information for patients within our institution (options of "choose not to disclose" and "no religious affiliation" are available). Subjects in this retrospective cohort study which conformed with the Declarations of Helsinki and Istanbul were separated into cohorts: LT recipients who self-reported religious affiliation and LT recipients who did not. All LT recipients between March 2007 and September 2018 who had available information regarding their reported religion were included. Excluded patients included those who received a multi-organ transplant, underwent re-transplantation, received a partial liver graft, and identified as agnostic. Outcomes included 30-day readmission, death, and the composite outcome of re-transplantation/death.

In an unadjusted analysis of 378 patients, there were no statistically significant differences between the two groups for 30-day readmission (OR=1.15, P=0.71), death (HR=0.63, P=0.19), or re-transplantation/death (HR=0.90, P=0.75). In multivariable analysis, adjusting for age at transplant and hospital admittance status when called for transplant, results were similar.

We found no statistically significant difference in the outcomes measured between patients with and without self-reported religious affiliation.

Further studies into the role of participation in religious activity and the impact of engagement with a religious community should be conducted in the future.

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