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Adherence in liver transplant recipients.

Patrizia Burra1, Giacomo Germani, Francesca Gnoato

  • 1Gastroenterology, Multivisceral Transplant Unit, Department of Surgical and Gastroenterological Sciences, University of Padua, Padua, Italy. burra@unipd.it

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
|March 9, 2011
PubMed
Summary

Liver transplant patients must adhere to medical regimens for successful outcomes. Nonadherence, especially to immunosuppressants, risks graft loss, with higher rates in pediatric patients and varied risk factors across age groups.

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Area of Science:

  • Transplant Medicine
  • Patient Adherence Research
  • Gastroenterology

Background:

  • Adherence to medical regimens is critical for liver transplant recipients.
  • Nonadherence to immunosuppression can lead to graft rejection and loss.
  • Nonadherence to general medical advice may cause de novo tumors and increased healthcare costs.

Purpose of the Study:

  • To review the literature on adherence in liver transplant patients.
  • To analyze the prevalence of nonadherence in adults versus pediatric/adolescent patients.
  • To identify and compare risk factors for nonadherence in different age groups.

Main Methods:

  • Literature review of published studies on liver transplant patient adherence.
  • Categorization of patients into adult and pediatric/adolescent groups.
  • Analysis of reported prevalence rates and risk factors for nonadherence.

Main Results:

  • Nonadherence rates to immunosuppressants in adults range from 15-40%; to appointments, 3-47%.
  • Nonadherence is nearly 4 times higher in pediatric/adolescent patients compared to adults.
  • Risk factors differ by age: adults face medication costs and psychiatric issues; younger patients experience psychological distress and family factors.

Conclusions:

  • Adherence is crucial for liver transplant success, with significant nonadherence rates observed.
  • Distinct risk factors necessitate tailored, multidisciplinary strategies for improving adherence in adult and pediatric populations.
  • A single approach is insufficient; personalized interventions are required for optimal patient outcomes.