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Immunosuppressant therapy adherence and graft failure among pediatric renal transplant recipients

M A Chisholm-Burns1, C A Spivey, R Rehfeld

  • 1College of Pharmacy, University of Arizona, Tucson, AZ, USA. chisholm@pharmacy.arizona.edu

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|August 18, 2009
PubMed

Insights

Improved immunosuppressant therapy (IST) adherence in pediatric kidney transplant recipients (RTRs) is linked to longer graft survival. Promoting adherence can optimize outcomes for these young patients.

Area of Science:

  • Nephrology
  • Immunology
  • Pediatric Transplantation

Background:

  • Pediatric renal transplant recipients (RTRs) require lifelong immunosuppressant therapy (IST) to prevent graft rejection.
  • Adherence to IST is crucial for long-term graft survival but can be challenging in pediatric populations.

Purpose of the Study:

  • To determine the association between immunosuppressant therapy adherence and graft failure in pediatric RTRs.
  • To evaluate the impact of adherence on graft survival rates using real-world data.

Main Methods:

  • Retrospective analysis of 877 pediatric RTRs from the United States Renal Data System (USRDS) with Medicare data.
  • Medication Possession Ratio (MPR) was used to measure IST adherence.
  • Cox proportional hazards analysis and Kaplan-Meier estimates assessed the relationship between adherence and graft failure.

Main Results:

  • Greater IST adherence was significantly associated with a longer time to graft failure (p = 0.009).
  • Kaplan-Meier analysis showed a significant difference in graft survival over time between adherent and nonadherent groups (p = 0.017).

Conclusions:

  • Adherence to immunosuppressant therapy is a critical factor for optimizing graft survival in pediatric renal transplant recipients.
  • Interventions to promote IST adherence among pediatric RTRs and their caregivers are recommended to improve long-term outcomes.

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