Evaluation Of Non-Adherence To Immunosuppressant Drugs Through Tacrolimus Test Among Post Liver Transplant Recipients At Pir Abdul Qadir Shah Jeelani Institute Of Medical Sciences Gambat. Sindh. Pakistan

Abstract

Medicinal Non-adherence after the hepatic transplant is correlated with harmful side effects including graft rejection (it develops when the immune system invades the donated organ and starts damaging or destroying the transplanted liver/organ) and graft loss (removal of graft, re-transplantation or expire of the recipients). 

Objectives: To determine the Non-adherence to Immunosuppressant Drugs in Post Liver Transplant Recipients.

Methodology: A Cross sectional study was performed on Liver Transplant recipients who have been discharged from Liver Transplant Department, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, after successful liver transplant. Tacrolimus test of enrolled patients was performed during follow up visits to check the serum concentration of immunosuppressant drug. Results: In this study patients were divided into different age groups, 13% belongs to 23-30 years of age, 16% were of 31-40 years, 21% were 41-50 years, 46% were of 51-60 years and 4% were of 61-70 years of age. Gender wise 59% were male, 41% were females. 64% were belongs to rural areas where as 36% belongs to urban areas. Literacy wise 68% study subjects were undergraduates, 27% were graduates and 5% patients were uneducated. Employment wise 26% patients were having government job, 55% were have private job and 19% were unemployed.  25% participants were transplanted in less than 1 year, 19% were have 1-2 years, 38% were have 2-3 years and 18% were have transplanted more than 3 years. 7% patients were prescribed 1-3 drugs, 40% were prescribed 3-5 drugs, 43% were prescribed 5-7 drugs and 10% participants were prescribed more than 7 drugs. Among total drugs 90% patients were prescribed 2 immunosuppressant drugs and 10% patients were prescribed 3 immunosuppressant drugs. Among all patients 32% patients were taking drugs on time where as 68% were not taking drugs on time. Serum Tacrolimus test results of 33% patients was in normal range while 67% patients were below normal range. Conclusion: The study concluded that the rate of Non-adherence to immunosuppressant drugs in post liver transplant recipient was very high.

Keywords: Adherence, Non-Adherence, Immunosuppressant, Liver Transplant.