Exploring the Interplay Between Depression, Anxiety, and Immune Tolerance in Liver Transplant Recipients

Objective: Liver transplantation requires lifelong immunosuppression, which has significant psychological and physiological implications. While depression and anxiety are prevalent among transplant recipients, their potential relationship with immune tolerance remains unclear. This study aims to evaluate the association between depression, anxiety, and immune tolerance in liver transplant (LT) recipients. Methods: This cross-sectional study included 179 adult LT recipients, categorized as tolerant (n=49) and nontolerant (n=130) based on immunosuppressive status. Depression and anxiety levels were assessed using the Beck Depression Inventory-II and Spielberger's State-Trait Anxiety Inventory. Data were analyzed using appropriate statistical tests, with significance set at p<.05. Results: A history of psychiatric disorders, including depression and anxiety, was observed in 19.0% and 53.1% of participants, respectively. No significant differences were found in Beck Depression Inventory-II scores between tolerant (13.14 +/- 10.67) and nontolerant (12.45 +/- 11.38) groups. Similarly, State-Trait Anxiety Inventory State and Trait anxiety scores did not differ significantly between groups (p=.23 for both). Conclusions: While depression and anxiety are common in LT recipients, this study did not find a significant association with immune tolerance. Given the cross-sectional design and sample size limitations, further longitudinal research is needed to determine whether psychological factors influence transplant outcomes.