Related Experiment Video
Updated: Apr 13, 2026

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Assessing pharmacologic and nonpharmacologic risks in candidates for kidney transplantation
Angela Q Maldonado1, Eric M Tichy2, Christin C Rogers2
1Angela Q. Maldonado, Pharm.D., BCPS, CPP, is Clinical Pharmacy Specialist, Department of Transplant Surgery, Vidant Medical Center, Greenville, NC. Eric M. Tichy, Pharm.D., FCCP, BCPS, is Clinical Pharmacy Specialist, Department of Pharmacy, Yale-New Haven Hospital, New Haven, CT. Christin C. Rogers, Pharm.D., FCCP, BCPS, is Clinical Pharmacy Coordinator, Department of Pharmacy, Beth Israel Deaconess Medical Center, Boston, MA. MayaCampara, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Department of Pharmacy, University of Illinois at Chicago. ChristopherEnsor, Pharm.D., BCPS, is Clinical Pharmacy Specialist, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA. ChristinaT. Doligalski, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Department of Pharmacy, Tampa General Hospital, Tampa, FL. Steven Gabardi, Pharm.D., FCCP, BCPS, is Clinical Pharmacy Specialist, Departments of Transplant Surgery and Pharmacy and Renal Division, Brigham and Women's Hospital, Boston, MA. JillianL. Descourouez, Pharm.D., BCPS, is Clinical Pharmacy Specialist, Department of Pharmacy, University of Wisconsin Hospital and Clinics, Madison. Ian C. Doyle, Pharm.D., BCPS, is Assistant Professor, School of Pharmacy, Pacific University, Hillsboro, OR. JenniferTrofe-Clark, Pharm.D., FCCP, BCPS, is Clinical Pharmacy Specialist, Department of Pharmacy Services, Hospital of the University of Pennsylvania, Philadelphia, and Adjunct Associate Professor, Renal Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania. angela.maldonado@vidanthealth.com.
Purpose:
Pharmacotherapy concerns and other factors with a bearing on patient selection for kidney transplantation are discussed.
Summary:
The process of selecting appropriate candidates for kidney transplantation involves multidisciplinary assessment to evaluate a patient's mental, social, physical, financial, and medical readiness for successful surgery and good posttransplantation outcomes. Transplantation pharmacists can play important roles in the recognition and stratification of pharmacologic and nonpharmacologic risks in prospective kidney transplant recipients and the identification of issues that require a mitigation strategy. Key pharmacotherapy-related issues and considerations during the risk assessment process include (1) anticoagulation concerns, (2) cytochrome P-450 isoenzyme-mediated drug interactions, (3) mental health-related medication use, (4) chronic pain-related medication use, (5) medication allergies, (6) use of hormonal contraception and replacement therapy, (7) prior or current use of immunosuppressants, (8) issues with drug absorption, (9) alcohol use, (10) tobacco use, (11) active use of illicit substances, and (12) use of herbal supplements. Important areas of nonpharmacologic risk include vaccine delivery, infection prophylaxis and treatment, and socially related factors such as nonadherent behavior, communication barriers, and financial, insurance, or transportation challenges that can compromise posttransplantation outcomes.
Conclusion:
Consensus opinions of practitioners in transplantation pharmacy regarding the pharmacologic and nonpharmacologic factors that should be considered in assessing candidates for kidney transplantation are presented.
Related Concept Videos
Kidney Transplant I: Introduction
Kidney Transplant II: Surgical Procedure
Kidney Transplant III: Nursing Management
Acute Kidney Injury IV: Diagnostic Studies and Prevention
Drug Toxicity: Risk factors
Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu

