Outcome evaluation

Successful outcomes in solid organ transplantation are generally measured in terms of several separate end points: (a) preventing acute rejection, (b) increasing 1-year graft survival, (c) preventing immunosuppressive drug complications, and (d) improving long-term allograft and patient survival.

The short-term goals after organ transplantation revolve around reducing the incidence of acute rejection episodes and attaining a high graft survival rate. By accomplishing these goals, transplant clinicians hope to attain good allograft function to allow for an improved quality of life. These goals can be achieved through the appropriate use of medical immunosuppression and scrutinizing over the therapeutic and toxic monitoring parameters associated with each medication employed. In addition, transplant recipients should be monitored for adverse drug reactions, DDIs, and adherence with their therapeutic regimen.

The long-term goals after organ transplant are to maximize the functionality of the allograft and prevent the complications of immunosuppression, which lead to improved patient survival. Clinicians must play multiple roles in the long-term care of transplant recipients as, not only must the patient be followed from an immunolo-gic perspective, but practitioners must be focused in identifying and treating the adverse sequelae associated with lifelong immunosuppression including cardiovascular disease, malignancy, infection, and osteoporosis among others. Again, limiting drug misadventures and assuring adherence with the therapeutic regimen is important and should be stressed.

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