How should we retransplant patients after graft loss due to noncompliance?

  • Eduardo A. Santiago-delpin
Part of the Transplantation and Clinical Immunology book series (TRAC, volume 29)


Noncompliant behavior — considered for a long time as an important risk factor in cardiovascular and cancer treatments — is now being recognized as an important element in organ transplantation outcome. Its existence is most vexing to the members of the transplant team and to the patient’s family since it is universally recognized that a large amount of effort and sacrifice goes into organ donation and transplantation. Careful analysis of this problem is necessary in order to identify its exact prevalence, the magnitude of the problem, the importance of noncompliance in patient death and graft loss, as well as in other post transplant complications.


Organ Donation Renal Transplant Recipient Graft Loss Total Quality Management Noncompliant Patient 
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  1. 1.
    Najarian JS. The making of the Transplantation Society. Transplant. Proc. 1997; 29: 7–11.PubMedCrossRefGoogle Scholar
  2. 2.
    Adang EMM, Engel GL, Van Hoof JP, Koostra G. Comparison before and after transplantation of pancreas-kidney and pancreas-kidney with loss of pancreas-prospective controlled quality of life study. Transplantation 1996; 62: 754–758.PubMedCrossRefGoogle Scholar
  3. 3.
    Matas AJ, Lawson W, McHugh L et al. Employment patterns after successful kidney transplantation. Transplantation 1996; 61: 729–733.PubMedCrossRefGoogle Scholar
  4. 4.
    Matos-Alvarado D, Rodriguez-Palmer N, Santiago RI et al. La rehabilitación del paciente transplantado. Bol. Asoc. Med. P. Rico 1980; 72: 91–94.PubMedGoogle Scholar
  5. 5.
    Santiago-Delpín E, Amadeo JH, Ramírez-González R. Results of living related kidney transplantation in Puerto Rico. Transplantation 1986; 41: 606–610.PubMedCrossRefGoogle Scholar
  6. 6.
    Rettig RA. The social contract and the treatment of permanent kidney failure. JAMA 1996; 275: 1123–1126.PubMedCrossRefGoogle Scholar
  7. 7.
    Lewis RL, Canafax DM, Pettit KG et al. Use of Markov modelling for evaluating the cost-effectiveness of immunosuppressive therapies in renal transplant recipients. Transplant. Proc. 1996; 28: 2214–2217.PubMedGoogle Scholar
  8. 8.
    UNOS Update, United Network for Organ Sharing, Richmond, VA (USA). Jan 1997.Google Scholar
  9. 9.
    Santiago-Delpín EA. Organ donation and transplantation in Latin America. Transplant. Proc. 1991; 23: 2516–2518.PubMedGoogle Scholar
  10. 10.
    Fernández M, Zayas E, González ZA et al. Factors in a meager donation pattern of a Hispanic population. Transplant. Proc. 1991; 23: 1799–1801.PubMedGoogle Scholar
  11. 11.
    René PP, Viera E, Jiles R, Daniels DE. Organ donation awareness: Knowledge, attitudes and beliefs in a Puerto Rican Population. Transplant. Proc. 1995; 27: 1893–1896.PubMedGoogle Scholar
  12. 12.
    Santiago-Delpín EA, Duro-García V, Chameh O. Forty thousand organ transplants in Latin America. Transplant. Proc. 1997; 29: 1586–1589.PubMedCrossRefGoogle Scholar
  13. 13.
    Terasaki PI (ed.). Clinical kidney transplants-1985, UCLA Tissue Typing Lab. Los Angeles, CA (USA) 1985.Google Scholar
  14. 14.
    Terasaki PI, Cecka JM (eds.). Clinical transplants-1995, UCLA Tissue Typing Lab, Los Angeles, CA (USA), 1995.Google Scholar
  15. 15.
    Mahoney RJ, Norman DJ, Colombe BW et al. Identification of high-and low-risk second kidney grafts. Transplantation 1996; 61: 1349–1355.PubMedCrossRefGoogle Scholar
  16. 16.
    Tejani A, Sullivan EK. Factors that impact on the outcome of second transplants in children. Transplantation 1996; 62: 606–611.PubMedCrossRefGoogle Scholar
  17. 17.
    Hiesse C, Riev P, Larve JR et al. Late graft failure and death in renal transplant recipients: Analysis in a single-center population of 1500 patients. Transplant. Proc. 1997; 29: 240–242.PubMedCrossRefGoogle Scholar
  18. 18.
    Haÿry P, Yilmaz S. Chronic allograft rejection: An update. Transplant. Proc. 1994; 26: 3159–3160.PubMedGoogle Scholar
  19. 19.
    Didlake RH, Dreyfus KRH, Van Buren CT, Kahan BD. Patient non-compliance: A major cause of late graft failure in cyclosporine-treated renal transplants. Transplant. Proc. 1988; 10: 63–66.Google Scholar
  20. 20.
    Rovelli M, Palmieri D, Vossler E et al. Non-compliance in organ transplant recipients. Transplant. Proc. 1989; 21: 833–834.PubMedGoogle Scholar
  21. 21.
    Schweitzer RT, Rovelli M, Palmieri P et al. Non-compliance in organ transplant recipients. Transplantation 1990; 49: 374–376.CrossRefGoogle Scholar
  22. 22.
    Dunn J, Golden D, Van Buren C et al. Causes of graft loss beyond two years in the cyclosporine era. Transplantation 1990; 49: 349–352.PubMedCrossRefGoogle Scholar
  23. 23.
    Rodriguez A, Diaz M, Colón A, Santiago-Delpín EA. Psychosocial profile of non-compliant transplant patients. Transplant. Proc. 1991; 23: 1807–1809.PubMedGoogle Scholar
  24. 24.
    Meyers KEC, Weiland H, Thomson PD. Pediatrie renal transplantation non-compliance. Pediatr. Nephrol. 1995; 9: 189.PubMedCrossRefGoogle Scholar
  25. 25.
    Korsch BM, Fine RN, Negrete VF. Non-compliance in children with renal transplants. Pediatrics 1978; 61: 872.PubMedGoogle Scholar
  26. 26.
    Meyers KEC, Thomson PD, Weiland H. Non-compliance in children and adolescents after renal transplantation. Transplantation 1996; 26: 186–189.CrossRefGoogle Scholar
  27. 27.
    Pirsch JD, Ploeg RJ, Gange S et al. Determinants of graft survival after kidney transplantation. Transplantation 1996; 61: 1581–1586.PubMedCrossRefGoogle Scholar
  28. 28.
    Hilbrands LB, Hoitsma AJ, Koene RAP. Medication compliance after renal transplantation. Transplantation 1995; 60: 914–920.PubMedCrossRefGoogle Scholar
  29. 29.
    Troppmann C, Benedetti E, Gruessner RWG, Najarian JS, Matas AJ. Should patients with renal allograft loss due to non compliance be retransplanted? Transplant. Proc. 1995; 27: 1093.PubMedGoogle Scholar
  30. 30.
    Bumgardner GL, Henry ML, Elkhammas E et al. Obesity as a risk factor after combined pancreas/kidney transplantation. Transplantation 1995; 60: 1426–1430.PubMedCrossRefGoogle Scholar
  31. 31.
    Fabrega F, Foster PF, Sankary HN et al. Liver transplantation for patients with alcoholic cirrhosis. Transplant. Proc. 1997; 29: 465–466.PubMedCrossRefGoogle Scholar
  32. 32.
    Setaro JF, Black HR. Refractory Hypertension. N. Engl. J. Med. 1992; 327: 543–547.PubMedCrossRefGoogle Scholar
  33. 33.
    Simic S, Djukanovic L, Stojkovic D et al. Does suboptimal immunosuppression contribute to chronic rejection? Transplant. Proc. 1995; 27: 909–910.PubMedGoogle Scholar
  34. 34.
    De Geest S, Borgemans L, Genoets H et al. Incidence, determinants, and consequences of subclinical non compliance with immunosuppressive therapy in renal transplant recipients. Transplantation 1995; 59: 340–347.PubMedCrossRefGoogle Scholar
  35. 35.
    Sudan DL, Shaw BW, Langrias AN. Causes of late mortality in pediatric liver transplant recipients. Transplant. Proc. 1997; 29: 430–431.PubMedCrossRefGoogle Scholar
  36. 36.
    Garcia V, Bittar A, Keltel E et al. Patient non-compliance as a major cause of kidney graft failure. Transplant. Proc. 1997; 29: 252–254.PubMedCrossRefGoogle Scholar
  37. 37.
    Jacobs C. The word we call ‘Compliance’. Transplant. Chronicles 1996; 3: 17–18.Google Scholar
  38. 38.
    Meichenbaum D, Turk DC. Facilitating treatment adherence. Plenum Press, New York, 1987.Google Scholar
  39. 39.
    Rovelli M, Palmieri D, Vossler E et al. Non compliance in renal transplant recipients: Evaluation by socioeconomic groups. Transplant. Proc. 1989; l21: 3979–3980.Google Scholar
  40. 40.
    Kalil RSN, Hein-Duthoy KL, Kasiske BL. Patients with a low income have reduced renal allograft survival. Am. J. Kidney Dis. 1992; 10: 63.Google Scholar
  41. 41.
    Everett KD, Sletten C, Carmack C et al. Predicting non-compliance to fluid restrictions in hemodialysis patients. Dialysis Transplant. 1993; 22: 614–618.Google Scholar
  42. 42.
    Desmond FE, Tucker CM. Seasonal variation of fluid intake adherence in hemodialysis patients. Cont. Dial. Nephrol. March 1993: 15–16.Google Scholar
  43. 43.
    Perkins KA. Applicability of health promotion strategies to increasing organ donation. In: Shanteau J, Harris RJ (eds.), Organ Donation and Transplantation: Psychological and Behavioral Factors. American Psychological Association, Washington, DC; 1990: 179–188.Google Scholar
  44. 44.
    Souchet MM. La evaluation social y el grave problema de no-cumplimiento. Bol. Asoc. Med. P. Rico 1995; 87: 114–115.PubMedGoogle Scholar
  45. 45.
    Townsend ME, Rovelli MA, Schweitzer RT. Value of discussion groups in educating blacks about organ donation and transplantation. Transplant. Proc. 1990; 22: 324–325.PubMedGoogle Scholar
  46. 46.
    Beck DE, Fennell RS, Yost RL et al. Evaluation of an educational program on compliance with medication regimens in pediatric patients with renal transplants. J. Pediatr. 1980; 96: 1094.PubMedCrossRefGoogle Scholar
  47. 47.
    Ramos EL, Kasiske BL, Alexander SR et al. The evaluation of candidates for renal transplantation. Transplantation 1994; 57: 490–497.PubMedCrossRefGoogle Scholar
  48. 48.
    Matas AJ, Gillighan KJ, Payne WD et al. A third kidney transplant: Cost-effective treatment for end-stage renal disease? Clin. Transplant. 1996; 10: 516–520.PubMedGoogle Scholar

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© Kluwer Academic Publishers 1997

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  • Eduardo A. Santiago-delpin

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