RT Journal Article SR Electronic T1 Depressive symptoms in lung transplant recipients: trajectory and association with mortality and allograft dysfunction JF Thorax JO Thorax FD BMJ Publishing Group Ltd and British Thoracic Society SP 891 OP 899 DO 10.1136/thoraxjnl-2021-217612 VO 77 IS 9 A1 Kolaitis, Nicholas A A1 Gao, Ying A1 Soong, Allison A1 Greenland, John R A1 Hays, Steven R A1 Golden, Jeffrey A A1 Venado, Aida A1 Leard, Lorriana E A1 Shah, Rupal J A1 Kleinhenz, Mary Ellen A1 Katz, Patricia P A1 Kukreja, Jasleen A1 Blanc, Paul D A1 Smith, Patrick J A1 Singer, Jonathan Paul YR 2022 UL http://thorax.bmj.com/content/77/9/891.abstract AB Objective Most studies observing an association between depressive symptoms following lung transplantation and mortality are limited to depressive symptom measurement at a single time point, unrelated to allograft function. We aimed to test the association of depressive symptoms over multiple assessments with allograft dysfunction and with mortality.Methods We assessed depressive symptoms before and serially up to 3 years after lung transplantation in lung transplant recipients. We quantified depressive symptoms with the Geriatric Depression Scale (GDS; range 0–15; minimally important difference (MID): 2). We quantified changes in GDS using linear mixed effects models and tested the association with mortality using Cox proportional hazards models with GDS as a time-dependent predictor. To determine if worsening in GDS preceded declines in lung function, we tested the association of GDS as a time-dependent predictor with the lagged outcome of FEV1 at the following study visit.Results Among 266 participants, depressive symptoms improved early after transplantation. Worsening in post-transplant GDS by the MID was associated with mortality (HR 1.25, 95% CI 1.05 to 1.50), and in lagged outcome analyses with decreased per cent predicted FEV1 (Δ, −1.62%, 95% CI −2.49 to –0.76). Visual analyses of temporal changes in GDS demonstrated that worsening depressive symptoms could precede chronic lung allograft dysfunction.Conclusions Depressive symptoms generally improve after lung transplantation. When they worsen, however, there is an association with declines in lung function and mortality. Depression is one of the few, potentially modifiable, risk factors for chronic lung allograft dysfunction and death.Data are available upon reasonable request.