Managed care implications of improving long-term outcomes in organ transplantation

Refinements in solid organ transplantation techniques have resulted in improvements in patient and graft survival, and transplants are a cost-effective option for appropriate patients. Lack of improvement in graft survival, despite a reduction in acute rejection episodes, has sparked interest in both newer medications/treatment regimens and strategies to improve outcomes. Even as transplant professionals seek to optimize the therapeutic regimen for each patient, there are steps that managed care can take to further reduce costs and improve patient and graft survival. This review addresses factors that impact graft survival and focuses on the role of managed care clinicians in adherence assessment and improvement as a means to enhance patient and graft outcomes. Improvements in graft and patient survival are expected to preserve and maximize the usefulness of the limited supply of organ and financial-related resources in the United States.