According to a study published in the January issue of the American Journal of Transplantation, 94 percent of pediatric patients described as "compliant" with medication regimens for their kidney disease were recommended by physicians for transplant, compared to 62 percent who were labeled "not compliant."

Because organ rejection is the most serious complication following transplant, patient compliance with an anti-rejection medication regimen is critical, the researchers say, and may explain why physicians were strongly influenced by reports of the patient's prior history of compliance.

Lead author Susan L. Furth, M.D., Ph.D., a pediatric nephrologist at the Children's Center, cautions, however, that while physicians may assume non-compliance plays a role in rejection, they cannot know for certain who will actually be compliant after the transplant.

"Any physician or family concerns about ability to comply with post-transplant treatment regimens should be discussed openly to overcome potential barriers to kidney transplantation," she said.

For their study, the Johns Hopkins researchers surveyed a random sample of 316 pediatric and adult nephrologists from across the country. Each physician was presented with 10 hypothetical case scenarios of children and adolescents with kidney failure, including information on the patient's age, race, number of parents in the home, parents' educational level, and compliance history. Physicians were asked whether or not they would recommend transplantation.

Researchers also found the education level of the child's parents influenced transplantation recommendations. Children of more educated parents were more likely to be referred for transplantation, with 83 percent w
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Contact: Jessica Collins
jcolli31@jhmi.edu
410-516-4570
Johns Hopkins Medical Institutions
7-Jan-2003