php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Transplant Research and Risk Management 2016:8 31–36 Transplant Research and Risk Management Dovepress
{"title":"Is portal vein thrombosis still a contraindication for liver transplantation? A single-institute’s 5-year experience and literature review","authors":"Salman Ghazwani, F. Panaro, F. Navarro","doi":"10.2147/TRRM.S115351","DOIUrl":"https://doi.org/10.2147/TRRM.S115351","url":null,"abstract":"php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Transplant Research and Risk Management 2016:8 31–36 Transplant Research and Risk Management Dovepress","PeriodicalId":41597,"journal":{"name":"Transplant Research and Risk Management","volume":"8 1","pages":"31-36"},"PeriodicalIF":0.9,"publicationDate":"2016-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/TRRM.S115351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68494388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this review was to provide an update on hypothermic oxygenated perfusion as a preservation technique for whole organ allografts. Clinical and experimental data in heart, lung, liver, kidney, and pancreas/islet transplantation are summarized with a special emphasis on marginal donors and donation after circulatory death. The rationale behind hypothermic machine perfusion as well as its advantages and disadvantages compared to conventional cold storage and the competing technique, normothermic machine perfusion, are reviewed.
{"title":"Current perspectives in transplant medicine: hypothermic oxygenated perfusion","authors":"S. Michel, J. Madsen","doi":"10.2147/TRRM.S91510","DOIUrl":"https://doi.org/10.2147/TRRM.S91510","url":null,"abstract":"The purpose of this review was to provide an update on hypothermic oxygenated perfusion as a preservation technique for whole organ allografts. Clinical and experimental data in heart, lung, liver, kidney, and pancreas/islet transplantation are summarized with a special emphasis on marginal donors and donation after circulatory death. The rationale behind hypothermic machine perfusion as well as its advantages and disadvantages compared to conventional cold storage and the competing technique, normothermic machine perfusion, are reviewed.","PeriodicalId":41597,"journal":{"name":"Transplant Research and Risk Management","volume":"8 1","pages":"25-30"},"PeriodicalIF":0.9,"publicationDate":"2016-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/TRRM.S91510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68497865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Látos, G. Lázár, Z. Horváth, Victoria Wittmann, E. Szederkényi, Z. Hódi, P. Szenohradszky, M. Csabai
: Interdisciplinary studies suggest that the mental representations of the transplanted organ may have a significant effect on the healing process. The objective of this study was to examine the representations of the transplanted organ and their relationship with emotional and mood factors, illness perceptions, and the functioning of the transplanted organ. One hundred and sixty-four kidney transplant patients were assessed using the Spielberger Anxiety Inventory, the Beck’s Depression Scale, the Posttraumatic Growth Inventory, the Brief Illness Perception Questionnaire, and the Transplanted Organ Questionnaire. Medical parameters were collected from the routine clinical blood tests (serum creatinine and estimated glomerular filtration rate levels) and biopsy results. Our most outstanding results suggest that kidney-transplanted patients’ illness representations are associated with health outcomes. The Transplanted Organ Questionnaire “psychological rejection” subscale was connected with higher serum creatinine and estimated glomerular filtration rate levels. Logistic regression analysis showed that psychological rejection subscale, Brief Illness Perception Questionnaire, and Posttraumatic Growth Questionnaire total scores were associated with graft rejection. These results may serve as a basis for the development of complex treatment interventions, which could help patients to cope with the bio-psycho-social challenges of integrating the new organ as part of their body and self.
{"title":"Psychological rejection of the transplanted organ and graft dysfunction in kidney transplant patients","authors":"M. Látos, G. Lázár, Z. Horváth, Victoria Wittmann, E. Szederkényi, Z. Hódi, P. Szenohradszky, M. Csabai","doi":"10.2147/TRRM.S104133","DOIUrl":"https://doi.org/10.2147/TRRM.S104133","url":null,"abstract":": Interdisciplinary studies suggest that the mental representations of the transplanted organ may have a significant effect on the healing process. The objective of this study was to examine the representations of the transplanted organ and their relationship with emotional and mood factors, illness perceptions, and the functioning of the transplanted organ. One hundred and sixty-four kidney transplant patients were assessed using the Spielberger Anxiety Inventory, the Beck’s Depression Scale, the Posttraumatic Growth Inventory, the Brief Illness Perception Questionnaire, and the Transplanted Organ Questionnaire. Medical parameters were collected from the routine clinical blood tests (serum creatinine and estimated glomerular filtration rate levels) and biopsy results. Our most outstanding results suggest that kidney-transplanted patients’ illness representations are associated with health outcomes. The Transplanted Organ Questionnaire “psychological rejection” subscale was connected with higher serum creatinine and estimated glomerular filtration rate levels. Logistic regression analysis showed that psychological rejection subscale, Brief Illness Perception Questionnaire, and Posttraumatic Growth Questionnaire total scores were associated with graft rejection. These results may serve as a basis for the development of complex treatment interventions, which could help patients to cope with the bio-psycho-social challenges of integrating the new organ as part of their body and self.","PeriodicalId":41597,"journal":{"name":"Transplant Research and Risk Management","volume":"8 1","pages":"15-24"},"PeriodicalIF":0.9,"publicationDate":"2016-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/TRRM.S104133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68494141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Transplant Research and Risk Management 2016:8 9–13 Transplant Research and Risk Management Dovepress
{"title":"Tumor-resected kidney transplant - A quality of life survey","authors":"Siva Sundararajan, B. He, L. Delrivière","doi":"10.2147/TRRM.S94868","DOIUrl":"https://doi.org/10.2147/TRRM.S94868","url":null,"abstract":"terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Transplant Research and Risk Management 2016:8 9–13 Transplant Research and Risk Management Dovepress","PeriodicalId":41597,"journal":{"name":"Transplant Research and Risk Management","volume":"8 1","pages":"9-13"},"PeriodicalIF":0.9,"publicationDate":"2016-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/TRRM.S94868","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68497647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Transplant Research and Risk Management 2016:8 1–7 Transplant Research and Risk Management Dovepress
{"title":"Machine perfusion for improving outcomes following renal transplant: current perspectives","authors":"G. Franklin, R. Cannon","doi":"10.2147/TRRM.S64486","DOIUrl":"https://doi.org/10.2147/TRRM.S64486","url":null,"abstract":"License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Transplant Research and Risk Management 2016:8 1–7 Transplant Research and Risk Management Dovepress","PeriodicalId":41597,"journal":{"name":"Transplant Research and Risk Management","volume":"8 1","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2016-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/TRRM.S64486","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68497299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Perhaps as a consequence of increased obesity in the general population, the likelihood of obese patients receiving kidney transplants has more than doubled. Obesity confers increased risk for graft loss and death among renal transplant recipients. However, the relationship of changes in body weight and composition to outcome on the transplant waitlist and posttransplantation are not straightforward. Strategies to manage weight in the waitlisted and post-kidney transplantation patient must be performed in the context of a multidisciplinary approach and individualized to risk factors in particular patients. While retrospective studies offer considerable insight into the relationship between obesity and kidney transplant outcome, causal inferences must be made with great caution.
{"title":"Transplant surgery and the obese patient: special considerations","authors":"Prince Mohan, M. Kadian, T. Srinivas","doi":"10.2147/TRRM.S64014","DOIUrl":"https://doi.org/10.2147/TRRM.S64014","url":null,"abstract":"Perhaps as a consequence of increased obesity in the general population, the likelihood of obese patients receiving kidney transplants has more than doubled. Obesity confers increased risk for graft loss and death among renal transplant recipients. However, the relationship of changes in body weight and composition to outcome on the transplant waitlist and posttransplantation are not straightforward. Strategies to manage weight in the waitlisted and post-kidney transplantation patient must be performed in the context of a multidisciplinary approach and individualized to risk factors in particular patients. While retrospective studies offer considerable insight into the relationship between obesity and kidney transplant outcome, causal inferences must be made with great caution.","PeriodicalId":41597,"journal":{"name":"Transplant Research and Risk Management","volume":"7 1","pages":"71-81"},"PeriodicalIF":0.9,"publicationDate":"2015-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/TRRM.S64014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68497237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transplantation is the preferred treatment option for individuals with end-stage renal disease. Individuals who undergo transplantation must chronically be maintained on an immunosuppression regimen for rejection prophylaxis to help ensure graft survival. Current rejection prophylaxis consists of using a combination of calcineurin inhibitors, mTOR inhibi- tors, antimetabolite agents, and/or corticosteroids. These agents have collectively improved the short-term outcomes of renal transplantation, but improvements in late/chronic graft loss and recipient survival have lagged significantly behind challenging the field of transplantation to develop novel prophylactic agents. There have been several clinical trials conducted within the last 5 years in an attempt to bring such novel agents to the commercial market. These trials have resulted in the US Food and Drug Administration (FDA) approval of extended-release tacrolimus, as well as belatacept, which has the potential to replace calcineurin inhibitors for rejection prophylaxis. Other trials have focused on the development of novel calcineurin inhibitors (voclosporin), costimulation blockade (ASKP1240 and alefacept), kinase inhibitors (tofacitinib and sotrastaurin), and inhibitors of leukocyte migration (efalizumab). While these later agents have not been FDA-approved for use in transplantation, they remain noteworthy, as these agents explore pathways not previously targeted for allograft-rejection prophylaxis. The purpose of this review was to consolidate available clinical trial data with regard to the recent developments in rejection prophylaxis in kidney transplantation.
{"title":"Drugs in development for prophylaxis of rejection in kidney-transplant recipients","authors":"M. Sanders, A. Langone","doi":"10.2147/TRRM.S61446","DOIUrl":"https://doi.org/10.2147/TRRM.S61446","url":null,"abstract":"Transplantation is the preferred treatment option for individuals with end-stage renal disease. Individuals who undergo transplantation must chronically be maintained on an immunosuppression regimen for rejection prophylaxis to help ensure graft survival. Current rejection prophylaxis consists of using a combination of calcineurin inhibitors, mTOR inhibi- tors, antimetabolite agents, and/or corticosteroids. These agents have collectively improved the short-term outcomes of renal transplantation, but improvements in late/chronic graft loss and recipient survival have lagged significantly behind challenging the field of transplantation to develop novel prophylactic agents. There have been several clinical trials conducted within the last 5 years in an attempt to bring such novel agents to the commercial market. These trials have resulted in the US Food and Drug Administration (FDA) approval of extended-release tacrolimus, as well as belatacept, which has the potential to replace calcineurin inhibitors for rejection prophylaxis. Other trials have focused on the development of novel calcineurin inhibitors (voclosporin), costimulation blockade (ASKP1240 and alefacept), kinase inhibitors (tofacitinib and sotrastaurin), and inhibitors of leukocyte migration (efalizumab). While these later agents have not been FDA-approved for use in transplantation, they remain noteworthy, as these agents explore pathways not previously targeted for allograft-rejection prophylaxis. The purpose of this review was to consolidate available clinical trial data with regard to the recent developments in rejection prophylaxis in kidney transplantation.","PeriodicalId":41597,"journal":{"name":"Transplant Research and Risk Management","volume":"7 1","pages":"59-69"},"PeriodicalIF":0.9,"publicationDate":"2015-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/TRRM.S61446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68497050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: This review addresses psychosocial challenges before and after solid organ transplantation. Stressors, corresponding psychosocial changes of the recipient, and psychological interventions in the different phases of the transplant process are described. Furthermore, important aspects of the preoperative psychosocial evaluation are presented with a special focus on living donors and patients with alcoholic liver disease. For the postoperative period, adherence, quality of life, and return to work are highlighted. Finally, research and clinical implications are presented.
{"title":"Psychosocial challenges before and after organ transplantation","authors":"K. Schulz, S. Kroencke","doi":"10.2147/TRRM.S53107","DOIUrl":"https://doi.org/10.2147/TRRM.S53107","url":null,"abstract":": This review addresses psychosocial challenges before and after solid organ transplantation. Stressors, corresponding psychosocial changes of the recipient, and psychological interventions in the different phases of the transplant process are described. Furthermore, important aspects of the preoperative psychosocial evaluation are presented with a special focus on living donors and patients with alcoholic liver disease. For the postoperative period, adherence, quality of life, and return to work are highlighted. Finally, research and clinical implications are presented.","PeriodicalId":41597,"journal":{"name":"Transplant Research and Risk Management","volume":"7 1","pages":"45-58"},"PeriodicalIF":0.9,"publicationDate":"2015-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/TRRM.S53107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68497285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: Psychological assessments are crucial for the evaluation and optimization of the suitability of transplant patients. The interdisciplinary evaluation in modern transplantation medicine focuses on important psychosocial issues, such as assessing patients’ characteristics that predict best postoperative outcome after solid organ transplantation. When assessing patients for reconstructive hand transplantation, the psychological evaluation should identify whether reconstructive hand transplantation is the best treatment option to regain functionality and sensation, to resolve body image concerns, and to improve health-related quality of life (HRQOL) for each patient. These psychosocial issues in transplantation medicine are receiving increased attention; however, standardized psychological evaluation and follow-up protocols are still being developed. Previously published reports in transplantation medicine have attempted to identify psychosocial factors important in the evaluation of transplant patients and that predict psychosocial outcomes. This review will provide an overview of recent investigations in solid organ and vascularized composite allotransplantation (VCA), including the domains of evaluation, pre- and posttransplant follow-up, psychiatric complications, evaluation of body image, and HRQOL. Recent work highlights the potential for a multicenter research approach utilizing standardized assessment strategies and emphasizing the need for a shared assessment approach to understand psychosocial outcomes. For example, the Chauvet Workgroup convened in 2014 in Paris with stakeholders in the assessment of psychosocial factors to discuss key areas and propose an ongoing shared effort across centers in addressing important questions related to psychosocial care of VCA. A successful transplantation requires a multistaged multidisciplinary psychosocial evaluation to identify those most suited to solid organ or reconstructive transplantation and minimize psychological morbidity. With this in place, current transplant psychosocial practices can be useful for solid organ transplantation and refined for VCA. This review will present potential challenges and solutions for guideline development in both solid organ and VCA.
{"title":"Preoperative psychological evaluation of transplant patients: challenges and solutions","authors":"Martin Kumnig, Sheila G. Jowsey-Gregoire","doi":"10.2147/TRRM.S59268","DOIUrl":"https://doi.org/10.2147/TRRM.S59268","url":null,"abstract":": Psychological assessments are crucial for the evaluation and optimization of the suitability of transplant patients. The interdisciplinary evaluation in modern transplantation medicine focuses on important psychosocial issues, such as assessing patients’ characteristics that predict best postoperative outcome after solid organ transplantation. When assessing patients for reconstructive hand transplantation, the psychological evaluation should identify whether reconstructive hand transplantation is the best treatment option to regain functionality and sensation, to resolve body image concerns, and to improve health-related quality of life (HRQOL) for each patient. These psychosocial issues in transplantation medicine are receiving increased attention; however, standardized psychological evaluation and follow-up protocols are still being developed. Previously published reports in transplantation medicine have attempted to identify psychosocial factors important in the evaluation of transplant patients and that predict psychosocial outcomes. This review will provide an overview of recent investigations in solid organ and vascularized composite allotransplantation (VCA), including the domains of evaluation, pre- and posttransplant follow-up, psychiatric complications, evaluation of body image, and HRQOL. Recent work highlights the potential for a multicenter research approach utilizing standardized assessment strategies and emphasizing the need for a shared assessment approach to understand psychosocial outcomes. For example, the Chauvet Workgroup convened in 2014 in Paris with stakeholders in the assessment of psychosocial factors to discuss key areas and propose an ongoing shared effort across centers in addressing important questions related to psychosocial care of VCA. A successful transplantation requires a multistaged multidisciplinary psychosocial evaluation to identify those most suited to solid organ or reconstructive transplantation and minimize psychological morbidity. With this in place, current transplant psychosocial practices can be useful for solid organ transplantation and refined for VCA. This review will present potential challenges and solutions for guideline development in both solid organ and VCA.","PeriodicalId":41597,"journal":{"name":"Transplant Research and Risk Management","volume":"7 1","pages":"35-43"},"PeriodicalIF":0.9,"publicationDate":"2015-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/TRRM.S59268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68497295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: Nonadherence to immunosuppressant treatment is common after renal transplantation involving . 20% of patients. It is associated with cellular rejection, appearance of donor-specific antibodies, and chronic rejection. It has been estimated that nonadherence can be detected in approximately 50% of failing grafts. Since the evaluation of sociodemographic factors do not allow characterizing the target population, it is necessary to combine different measures of adherence (self-reporting and collateral reporting, pill counts, biological monitoring of blood samples, or others) to increase its diagnostic accuracy. During the last decade, it has been shown that the implementation of a multidimensional intervention including information, motivation, and behavioral interventions may lead to an improvement of adherence to treatment. On the other hand, it has been shown that one-off feedback from a nurse, simplification of treatment, or financial assistance programs offered little improvement. Thus, increasing the effectiveness of adherence interventions might have a far greater impact on the long-term outcome of renal transplants than any improvement in specific medical treatments. This will require coordinated action from health professionals, researchers, health planners, and policy makers.
{"title":"Nonadherence to immunosuppression: challenges and solutions","authors":"F. Moreso, I. Torres, G. Costa-Requena, D. Serón","doi":"10.2147/TRRM.S50796","DOIUrl":"https://doi.org/10.2147/TRRM.S50796","url":null,"abstract":": Nonadherence to immunosuppressant treatment is common after renal transplantation involving . 20% of patients. It is associated with cellular rejection, appearance of donor-specific antibodies, and chronic rejection. It has been estimated that nonadherence can be detected in approximately 50% of failing grafts. Since the evaluation of sociodemographic factors do not allow characterizing the target population, it is necessary to combine different measures of adherence (self-reporting and collateral reporting, pill counts, biological monitoring of blood samples, or others) to increase its diagnostic accuracy. During the last decade, it has been shown that the implementation of a multidimensional intervention including information, motivation, and behavioral interventions may lead to an improvement of adherence to treatment. On the other hand, it has been shown that one-off feedback from a nurse, simplification of treatment, or financial assistance programs offered little improvement. Thus, increasing the effectiveness of adherence interventions might have a far greater impact on the long-term outcome of renal transplants than any improvement in specific medical treatments. This will require coordinated action from health professionals, researchers, health planners, and policy makers.","PeriodicalId":41597,"journal":{"name":"Transplant Research and Risk Management","volume":"7 1","pages":"27-34"},"PeriodicalIF":0.9,"publicationDate":"2015-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/TRRM.S50796","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68495694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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