Differences in Medication Adherence between Living and Deceased Donor Kidney Transplant Patients
- PMID: 25013673
- PMCID: PMC4089329
Differences in Medication Adherence between Living and Deceased Donor Kidney Transplant Patients
Abstract
Background: Literature review suggests that adherence to immunosuppressive drugs may be lower in recipients of living than of deceased donor kidney grafts, possibly because of profile differences.
Objective: To compare the level of immunosuppressive adherence levels between patients with deceased and living (-related; -unrelated) donor grafts in Switzerland.
Methods: Using data from two similar cross-sectional studies at two transplant centers in Switzerland, the level of adherence between the two groups was compared. Medication adherence was assessed by self-report or electronic monitoring. Possible explanatory factors included age, beliefs regarding immunosuppressive drugs, depressive symptomatology, pre-emptive transplantation, and the number of transplants received, were also considered. Data were analyzed using logistic regression analysis.
Results: Unadjusted non-adherence odds were 2 to 3 times higher in living-related than deceased donor transplantation (ORs: 2.09-3.05; p<0.05). Adjustment for confounders showed that these differences were associated most with the younger age of living-related subjects and the belief that immunosuppressive drugs are less important for living-related donations.
Conclusion: There is a lower immunosuppressive adherence in recipients of living-related donor kidneys, possibly owing to differences in patient profile (ie, health beliefs regarding their immunosuppressive needs), knowledge of which may enhance adherence if addressed.
Keywords: Donor; Graft; Immunosuppressant adherence; Kidney transplantation; Living related transplantation.
References
-
- Kaminota M. Cost-effectiveness analysis of dialysis and kidney transplants in Japan. Keio J Med. 2001;50:100–8. - PubMed
-
- de Wit GA, Ramsteijn PG, de Charro FT. Economic evaluation of end stage renal disease treatment. Health Policy. 1998;44:215–32. - PubMed
-
- Liem YS, Weimar W. Early living-donor kidney transplantation: a review of the associated survival benefit. Transplantation. 2009;87:317–8. - PubMed
-
- Naderi GH, Mehraban D, Kazemeyni SM, et al. Living or deceased donor kidney transplantation: a comparison of results and survival rates among Iranian patients. Transplant Proc. 2009;41:2772–4. - PubMed
-
- Davis CL, Delmonico FL. Living-donor kidney transplantation: a review of the current practices for the live donor. J Am Soc Nephrol. 2005;16:2098–110. - PubMed
LinkOut - more resources
Full Text Sources