Non-Adherence To Organ Transplantation

A major, worldwide public health issue exists that many, if not most, people are either unaware of or, at best, paid little heed to. It is the issue of organ donations. Many thousands of people in countless countries suffer from major health issues that require these people receive organ transplants. If they do not receive these transplants, they will die from organ failure (Cohen, Bistritz, & Ashkenazi, 2015; Kennedy, 1979). The problem is that there are only a relatively few number of organs available for transplant compared to the number of people who need transplants (Jahromi, Fry-Revere, & Bastani, 2015).

Immunosuppressants are a class of drugs that suppress, or reduce, the strength of the body’s immune system. Some of these drugs are used to make the body less likely to reject a transplanted organ. Other immunosuppressant drugs are often used to treat autoimmune disorders. With an autoimmune disease, the immune system attacks the body’s own tissue. Because immunosuppressant drugs weaken the immune system, they weaken this reaction. It helps reduce the impact on the body. Almost everyone who receives an organ transplant must take immunosuppressant drugs. This is because your immune system sees a transplanted organ as a threat. As a result your immune system attacks the organ as it would attack anything else. This can cause severe damage and lead to needing the organ removed. The drugs allow the transplanted organ to remain healthy and free from major damage. If you’re an organ recipient, even the slightest change from the medication regimen can trigger an organ rejection. All immunosuppressant drugs carry the serious risk of infection. It also means that any infections get will be harder to treat. (Immunosuppressant drugs,

There are numerous problems dealing with organ transplantation. A major issue concerning organ transplantation is that organ donors are deficient and scarce. Donors have been known to scarce because not everyone takes good care of his or her body. There are not enough people to donate organs, yet the amount of people in need of organs is increasing by the hour. “Another conflict is organ transplants can still lead to other medical problems. This is usually because of the medicine you need to suppress your immune system” (Nazario Brunilda , “Common”). After an organ transplants, it is a must that you continuously take your medication; a sudden stop will most likely cause the immune system to reject the organ. “The medications can also raise your blood pressure and can cause osteoporosis due to loss of calcium” (Etienne, Flueridor Wendy).

The aim of present work was to develop and evaluate risperidone (BCS Class II drug from antipsychotic category) nanosuspension stabilized with combination of Polycaprolactone (PCL) and Pluronic® F-68 as stabilizers. Lyophilization as solidification method was accessed for its suitability with selective cryoprotectants (Trehalose dihydrate and sorbitol). Various process parameters affecting average particle size and PDI were optimized. Formulation was found to be stable at 5°C for 3 months. Cumulative drug release profile obtained shown developed nanosuspension formulation to be giving cumulative % release of ~50% in initial 10 hours whereas value for unprocessed drug was ~11% in same time frame. These findings suggest that developed

Organ donation could save the life of so many Individuals. One organ donor can save or significantly improve the lives of a minimum of seven others (Morgan, 2004). There has been a severe shortage in the availability of organ for transplantation. Presently, more than 40,000 patients in the United States are expecting organ transplants and it is guesstimated that about 60,000 people die yearly due to limited availability of organ for transplantation (Skumanich et al., 1996). The demand for organ donor is rising as transplant surgery turn out to be increasingly popular and successful in saving the lives of many individuals. Card

Many molecules, particularly peptides and polypeptides are physically embedded in polymers to create a complex network of interconnecting pores through which the drug could subsequently diffuse. The pore structure and polymer composition is controlled in order to design systems that release the drug at nearly any rate and for nearly

Organ donation has been perceived as an effective way of curing chronic illnesses that were fatal in the past. As a portrayal of medical progress, it reflects the concatenated efforts of medical research that has paved way for better health in the society. Vast efforts have been placed by various governmental and non-governmental organizations to enhance successful transplantation as well as the identification of donors. Although instances of organ rejection are occasional, continuous improvement has reduced these patterns. Mainly, there are two approaches through which organs for transplant are acquired. The first way is the donation of an organ by a living

Adherence to immunosuppressive medication in renal transplantation is imperative for graft survival. Non-adherence is one the major cause of graft failure post-transplant. Non-adherence can be described as not taking medications, missing medications, wrong timings, not taking proper dosages, anything that does follow the prescribed treatment regimen. (….) In some studies non-adherence can be as high as 70% of patients. (…) Renal failure due to non-compliance of treatment regimen is economically, socially and morally inexcusable.

The basis of Starzl’s innovation in transplantation stems from immunosuppressants. Immunosuppressants, such as azathioprine, which Starzl administered, are drugs that either partially or completely suppress the immune response in order to aid the survival of a transplanted organ so that the body does not reject it. Starzl used azathioprine to test the success of kidney transplants using canine models. Since the tests were successful, Starzl used the protocol on human patients and was the first to perform repeatedly successful kidney transplantations. Similarly to his kidney transplant procedure, Starzl also used dogs to model his liver transplant. He used canine donors and experimented to see how transplants affect the blood flow to the liver, but did not use immunosuppression at firstf. Starzl attempted to replace five livers between March 1, 1963 and October 4 of the same year. The first patient died on the operating table and the remaining four died roughly one-to-three weeks after the procedure. Two other doctors also attempted the procedure, but it seemed as though it could not be done. However, Starzl did not give up. In the twelve-year span between 1967 and 1979, more than fifty percent of Starzl’s patients died about a year after their transplant. When Starzl began to use azathioprine, the same immunosuppressant from his kidney procedures, eleven of the first twelve patients survived longer than a year after their transplant. Therefore, Starzl had successfully changed the status of the liver transplant from “feasible but impractical” to a “clinical

It was interesting to gain some insights into the important interactions between the immune system and organ transplantation. The seminar outlined the underlying principles of immunosuppressant therapy and introduced different types of drugs that can be used to minimized transplant rejection. In addition, the seminar highlighted some common types of infections within the transplanted population and the need to strike a fine balance between suppressing the immune system and allowing patient to fight against infections. The most interesting part of the presentation was the major roles social and psychological factors that can play in influencing patient’s drug adherence. This reminded me of a clinical case I experienced during one of my observations regarding a patient who almost lost his graft due to drug nonadherences. This underscores how the medical field is an integrated field that requires the collaboration of knowledge from both social and scientific perspectives. During the week, I worked efficiently on completing the scanning and shredding task for the Transplant Admissions and Medical History binder. I was able to complete the task one day after it was assigned. On Friday, I attended the research in progress meeting. It was really interesting to see the diverse types of project people are working on within the program. I was quite impressed and excited by the proposed video and web development projects aimed to increase the publicity of our program. Lastly, during the week I had a meeting with Dr. Kim regarding the DCAP project. The meeting greatly clarified the objectives of the DCAP and highlighted key components to include. After the meeting, I scheduled a brainstorming session with my research partner Yoonsik to set specific objectives, targets and timelines for the project. On Sunday, I

A successful transplant procedure is comparable to winning a battle, surviving after the fact wins the war. Very rarely is there a pair of patients that are immunologically identical. Identical twins are usually immunologically identical, but what about the other ninety percent of the human race? Many years ago this was a problem. At that time, the next step was to expand the promise of organ transplantation to the much larger pool of patients. Physicians realized that tools were needed to control the immune system to prevent rejection of allogeneic organs. Year after year, physicians all over the world discovered more reliable ways, in hope to completely rule out rejection of allogeneic organs. In 2004, Roy Calne, Jean Borel, and David White discovered a compound, by the name of “Cyclosporine A.” This compound represents the single most dramatic advance in immunosuppression to date. This medical discovery offered a high degree of potency and immune specificity heretofore unimagined, which lowered the rates for the chances of acute rejection by a substantial

Immune-suppressing drugs used may also have side effects viz. kidney damage, infections, diabetes etc. Long term survival rate is not as promising as other organ transplants. Rejection of new lungs can be slowed but cannot be stopped entirely.

Organ transplantation is a surgical procedure that involves replacing a failed organ with a healthy organ donated by another individual. Organ transplantation is often reserved as a last resort therapeutic option in certain individuals with end-stage organ disease. It is generally an option in individuals that have a life expectancy of 10 or more years. Patients frequently have to undergo a series of laboratory tests including screening for infectious diseases (eg, HIV, CMV, hepatitis B and C, tuberculosis) and other conditions prior to being considered a transplant candidate. Individuals are also normally tested for illicit drug use and screened for coexisting psychological disorders

Two of their main characteristics allows a major advantage over non-biodegradable delivery systems. Biodegradability is an important first characteristic of the polymer, and thus not required to remove it. The second one being the release rate more regular and less dependent on the intrinsic property of the polymer used. Commercially, Poly lactic acid as a polymeric carrier is the choice on account of their harmlessness to the human body. As cognized, the smaller particles give rise to faster release rates and hence used in this study for drug delivering

Oral administration is the most resourceful, convenient and major mode of drug delivery and is associated with superior patient compliance as compared to other modes of drug intake (1). Approximately 50% of drug delivery systems present in the market are oral drug delivery system (2). But main difficulty encounter in oral formulation (as estimated more than 50% of oral formulations are found to be poorly water soluble) has low bioavailability, giving increase to additional problems like high inter and intra subject variability , lack of dose uniformity and finally leading to therapeutic failure. The challenging mission is to increase the bioavailability of drugs (3). To overcome this difficulty, the oral controlled release (CR) formulations have been developed , as these will release the drug slowly into GIT and continue the constant drug concentration in the serum for a long period of time(4).