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Taking medications: A way to honor the donor family

iStock_000064287767_Medium This post was co-authored by Andrea Barton, clinical pharmacy specialist, and Shelly Kim, clinical pharmacy specialist.

Texas Children’s Hospital provides a second chance at life for hundreds of children through organ transplantation. The hospital specializes in heart, kidney, liver and lung transplants. In addition to transplanting single organs, Texas Children's also transplants pediatric patients who need multiple organs, such as heart and lungs or kidney and liver. Organ transplantation requires a team of health care members who work closely together to provide the best quality of care to patients. Members that make up this multidisciplinary team include surgeons, physicians, coordinators, nurses, pharmacists, dietitians, social workers, child life specialists, as well as other health care professionals who specialize in the care of transplant patients.

A child in need of a transplant is evaluated by the members of the transplant team. If a child is approved for transplantation, he or she is added to the national transplant waiting list. When donor organs become available, a computer system generates a ranked list of transplant candidates who are suitable to receive each organ. Many factors are involved to determine who will receive the donor organ(s), such as blood type, tissue type, medical urgency, waiting time and geographic location.

Once a patient receives an organ transplant, they must take medication(s) for the rest of their life. Because the recipient’s body recognizes the new organ(s) as foreign, the immune system will “attack” it. However, medications that suppress the immune system are taken to prevent rejection. The anti-rejection medication doses must be taken in a consistent manner either with or without food and on-time each day. When doses are missed or taken inconsistently, the amount of medication in the blood may become too low which increases the chance for rejection. Missing just one dose can increase the chance of the body rejecting the new organ(s). Transplant patients and caregivers are encouraged to use different techniques, such as cell phone alarms and medication apps with reminders to help remember to take each dose on-time. Other methods that can help families include the use of a pill box or organizer, having an up-to-date medication list on hand and establishing a daily routine of taking medications as instructed.

Interesting to note, is anti-rejection medications can interact with many other medications so it’s very important to speak with the transplant team prior to taking any new over-the-counter products, prescriptions drugs and herbal supplements. The transplant team will assess whether the new medication is safe to take. In addition, there are certain fruits and  juices that must be avoided after a transplant. These include grapefruit, pomegranate, star fruit and Seville oranges (orange marmalade). These fruits and their juices prevent the body from breaking down one of the anti-rejection medications which can lead to serious side effects and an increased risk of infection. It is important to always read ingredient labels to ensure none of the fruits listed above are included. Taking medications as instructed by the transplant team is extremely important to protect the precious gift of life and a way to honor the donor family.

As of March 25, 2016 there were 132,506 patients on the national transplant waiting list. Unfortunately, not all patients who need a transplant will receive one in time due to the significant shortage of available donor organs. April is National Donate Life month. Help provide hope to those who are waiting by registering to become an organ donor today! Visit http://donatelife.net/understanding-donation/ to learn more about becoming a donor in your state. To learn more about transplantation at Texas Children's, please visit http://www.texaschildrens.org/departments/transplant-services.

Author
Andrea Barton, clinical pharmacy specialist