Context: Knowing the prevalence and risk factors of immunosuppression nonadherence after liver transplant may help guide intervention development.

Objective: To examine whether sociodemographic and psychosocial variables before liver transplant are predictive of nonadherence after liver transplant.

Design: Structured telephone interviews were used to collect self-report immunosuppression adherence and health status information. Medical record reviews were then completed to retrospectively examine the relationship between immunosuppression adherence and pretransplant variables, including sociodemographic and medical characteristics and the presence or absence of 6 hypothesized psychosocial risk factors.

Setting And Participants: A nonprobability sample of 236 adults 6 to 24 months after liver transplant at 2 centers completed structured telephone interviews.

Main Outcome Measure: Immunosuppressant medication nonadherence, categorized as missed-dose and altered-dose "adherent" or "nonadherent" during the past 6 months; immunosuppression medication holidays.

Results: Eighty-two patients (35%) were missed-dose nonadherent and 34 patients (14%) were altered-dose nonadherent. Seventy-one patients (30%) reported 1 or more 24-hour immunosuppression holidays in the past 6 months. Missed-dose nonadherence was predicted by male sex (odds ratio, 2.46; P= .01), longer time since liver transplant (odds ratio, 1.08; P= .01), pretransplant mood disorder (odds ratio, 2.52; P=.004), and pretransplant social support instability (odds ratio, 2.25; P=.03). Altered-dose nonadherence was predicted by pretransplant mood disorder (odds ratio, 2.15; P= .04) and pretransplant social support instability (odds ratio, 1.89; P= .03).

Conclusion: Rates of immunosuppressant nonadherence and drug holidays in the first 2 years after liver transplant are unacceptably high. Pretransplant mood disorder and social support instability increase the risk of nonadherence, and interventions should target these modifiable risk factors.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127806PMC
http://dx.doi.org/10.7182/pit2013501DOI Listing

Publication Analysis

Top Keywords

liver transplant
24
odds ratio
24
pretransplant mood
12
mood disorder
12
social support
12
support instability
12
nonadherence
8
immunosuppression nonadherence
8
months liver
8
health status
8

Similar Publications

Background: Helicobacter pylori bacteria colonize the gastric mucosa and contribute to the occurrence and development of gastrointestinal diseases. According to the WHO, H. pylori bacteria are considered class I carcinogen.

View Article and Find Full Text PDF

Background: Larsucosterol is a DNA methyltransferase inhibitor in development for alcohol-associated hepatitis (AH), a disease for which there is no approved therapy.

Methods: In this phase 2b trial, patients with severe AH were randomly assigned 1:1:1 to receive 30 mg or 90 mg of larsucosterol or placebo; a second dose was administered after 72 hours if the patient remained hospitalized. All patients received supportive care as determined by investigators.

View Article and Find Full Text PDF

Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) are two distinct pulmonary vascular complications seen in patients with liver disease and/or portal hypertension. HPS is characterized by disturbed gas exchange and hypoxemia because of intrapulmonary vascular dilatations. POPH is defined by pulmonary arterial hypertension, which might lead to right heart failure.

View Article and Find Full Text PDF

Comparative dissection of transcriptional landscapes of human iPSC-NK differentiation and NK cell development.

Life Med

August 2024

The Bone Marrow Transplantation Center of The First Affiliated Hospital &Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou 310012, China.

Clinical and preclinical research has demonstrated that iPSC-derived NK (iNK) cells have a high therapeutic potential, yet poor understanding of the detailed process of their differentiation and their counterpart cell development has hindered therapeutic iNK cell production and engineering. Here we dissect the crucial differentiation of both fetal liver NK cells and iNK cells to enable the rational design of advanced iNK production protocols. We use a comparative analysis of single-cell RNA-seq (scRNA-seq) to pinpoint key factors lacking in the induced setting which we hypothesized would hinder iNK differentiation and/ or functionality.

View Article and Find Full Text PDF

Laparoscopic hepatectomy using indocyanine green attenuates postoperative inflammatory response for hepatocellular carcinoma: A propensity score matching analysis.

World J Gastrointest Surg

January 2025

Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

Background: Improving the intraoperative and postoperative performance of laparoscopic hepatectomy was quite a challenge for liver surgeons.

Aim: To determine the benefits of indocyanine green (ICG) fluorescence imaging in patients with hepatocellular carcinoma (HCC) who underwent laparoscopic hepatectomy during and after surgery.

Methods: We retrospectively collected the clinicopathological data of 107 patients who successfully underwent laparoscopic hepatectomy at Zhongshan Hospital (Xiamen), Fudan University from June 2022 to June 2023.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!