Title: Comorbid Psychiatric Disorders and Long-Term Survival after Liver Transplantation in
Transplant Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective
Study
Version: 2 Date: 31 Jan 2023
Reviewer's report:
This is a retrospective, non-randomized, observational study report with the title “Comorbid
Psychiatric Disorders and Long-Term Survival after Liver Transplantation in Transplant
Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective Study”.
Although the authors had made many revisions to the manuscript according to the reviewer’s
suggestion and the reviewer could accept the revisions made for the first review, the authors
should consider the impact for liver transplantation care in psychiatry. The reviewer has the
following questions about this manuscript:
1. The reviewer noted some errors in the tables of this manuscript. The manuscript stated
that “Table 1 shows the demographic characteristics of liver transplant recipients. The CP
group contained more participants who were older, single, had fewer years of education, higher
MELD score, and longer hospitalization than the N-CP group.” However, Table 1 showed lower
participants in the CP group who were single (71 versus 387 in the non-CP group) and had fewer
years of education (10.41 ±4.99 versus 4.73 ±5.94 in the non-CP group).
2. The manuscript is not clear on what the definition of ‘Survival rate at the end point’ is as
written in Table 3 and 5.
3. The manuscript stated in the background that “A comprehensive meta-analysis of comorbid
psychiatric disorders in organ transplant recipients(3) demonstrated that recipients who present
with depression prior to and immediately after transplantation have 1.65 times the risk of
postoperative mortality compared with those without comorbid psychiatric disorders.” Also, the
manuscript stated that “Delirium and major depressive disorder were significantly associated
with shorter survival time, but insomnia was not (Table 3).” However, after further discussion
of the statistics, the manuscript then states that “The results showed that delirium, insomnia,
and major depressive disorder did not significantly affect survival.” Why does this outcome not
match other studies?
4. This is common knowledge that delirium influences prognosis of liver transplantation
recipients, which also results in longer hospitalization. Age, delirium, and hospitalization are
all covariates for survival time. The onset of delirium and resulting hospitalization days are
not a meaningful consideration for psychiatric consultation. Longer hospitalization days may
be necessary for the effort to save patients, which is common sense. The reviewer suggests the
authors remove the factor of hospitalization days from the regression models.
Title: Comorbid Psychiatric Disorders and Long-Term Survival after Liver Transplantation in
Transplant Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective
Study
Version: 2 Date: 31 Jan 2023
Reviewer's report:
This is a retrospective, non-randomized, observational study report with the title “Comorbid
Psychiatric Disorders and Long-Term Survival after Liver Transplantation in Transplant
Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective Study”.
Although the authors had made many revisions to the manuscript according to the reviewer’s
suggestion and the reviewer could accept the revisions made for the first review, the authors
should consider the impact for liver transplantation care in psychiatry. The reviewer has the
following questions about this manuscript:
1. The reviewer noted some errors in the tables of this manuscript. The manuscript stated
that “Table 1 shows the demographic characteristics of liver transplant recipients. The CP
group contained more participants who were older, single, had fewer years of education, higher
MELD score, and longer hospitalization than the N-CP group.” However, Table 1 showed lower
participants in the CP group who were single (71 versus 387 in the non-CP group) and had fewer
years of education (10.41 ±4.99 versus 4.73 ±5.94 in the non-CP group).
2. The manuscript is not clear on what the definition of ‘Survival rate at the end point’ is as
written in Table 3 and 5.
3. The manuscript stated in the background that “A comprehensive meta-analysis of comorbid
psychiatric disorders in organ transplant recipients(3) demonstrated that recipients who present
with depression prior to and immediately after transplantation have 1.65 times the risk of
postoperative mortality compared with those without comorbid psychiatric disorders.” Also, the
manuscript stated that “Delirium and major depressive disorder were significantly associated
with shorter survival time, but insomnia was not (Table 3).” However, after further discussion
of the statistics, the manuscript then states that “The results showed that delirium, insomnia,
and major depressive disorder did not significantly affect survival.” Why does this outcome not
match other studies?
4. This is common knowledge that delirium influences prognosis of liver transplantation
recipients, which also results in longer hospitalization. Age, delirium, and hospitalization are
all covariates for survival time. The onset of delirium and resulting hospitalization days are
not a meaningful consideration for psychiatric consultation. Longer hospitalization days may
be necessary for the effort to save patients, which is common sense. The reviewer suggests the
authors remove the factor of hospitalization days from the regression models.
Please review this paper.
user
Title: Comorbid Psychiatric Disorders and Long-Term Survival after Liver Transplantation in
Transplant Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective
Study
Version: 2 Date: 31 Jan 2023
Reviewer's report:
This is a retrospective, non-randomized, observational study report with the title “Comorbid
Psychiatric Disorders and Long-Term Survival after Liver Transplantation in Transplant
Facilities with a Psychiatric Consultation-Liaison Team: a Multicenter Retrospective Study”.
Although the authors had made many revisions to the manuscript according to the reviewer’s
suggestion and the reviewer could accept the revisions made for the first review, the authors
should consider the impact for liver transplantation care in psychiatry. The reviewer has the
following questions about this manuscript:
1. The reviewer noted some errors in the tables of this manuscript. The manuscript stated
that “Table 1 shows the demographic characteristics of liver transplant recipients. The CP
group contained more participants who were older, single, had fewer years of education, higher
MELD score, and longer hospitalization than the N-CP group.” However, Table 1 showed lower
participants in the CP group who were single (71 versus 387 in the non-CP group) and had fewer
years of education (10.41 ±4.99 versus 4.73 ±5.94 in the non-CP group).
2. The manuscript is not clear on what the definition of ‘Survival rate at the end point’ is as
written in Table 3 and 5.
3. The manuscript stated in the background that “A comprehensive meta-analysis of comorbid
psychiatric disorders in organ transplant recipients(3) demonstrated that recipients who present
with depression prior to and immediately after transplantation have 1.65 times the risk of
postoperative mortality compared with those without comorbid psychiatric disorders.” Also, the
manuscript stated that “Delirium and major depressive disorder were significantly associated
with shorter survival time, but insomnia was not (Table 3).” However, after further discussion
of the statistics, the manuscript then states that “The results showed that delirium, insomnia,
and major depressive disorder did not significantly affect survival.” Why does this outcome not
match other studies?
4. This is common knowledge that delirium influences prognosis of liver transplantation
recipients, which also results in longer hospitalization. Age, delirium, and hospitalization are
all covariates for survival time. The onset of delirium and resulting hospitalization days are
not a meaningful consideration for psychiatric consultation. Longer hospitalization days may
be necessary for the effort to save patients, which is common sense. The reviewer suggests the
authors remove the factor of hospitalization days from the regression models.
assistant