Disability following kidney transplantation: the link to medication coverage

There is no uniformity regarding patient disability following kidney transplantation. Given improved results of patient and graft survival, and the link between insurance, medication coverage and disability, efforts must be made to define disability after a successful transplant. We conducted an individual questioner study of kidney transplant patients to determine factors relating to patient-perceived disability. Seventy patients participated in the study. Patient perception of disability did not correlate with education or ethnicity. Most patients believed they were disabled on dialysis and this did not change following transplantation. While 42 (60%) of the patients felt that they could work, either full-time or part-time, only 20 (28%) were actually working or in school. Most patients believe that working will eliminate disability status and, therefore, insurance and medication coverage. Patients considered disability more related to their status as a kidney transplant patient than any specific physical limitations. The link, whether real or perceived, between 'disability' and immunosuppressive medication coverage is a significant barrier for many patients. The transplant community must reach some degree of consensus regarding post-transplant activity restrictions. The transplant community needs to find a way to take an active role in post-transplant education and employment.