title: Noncompliance with medications in pediatric patients after living-donor liver transplantation.
abstract: BACKGROUND
  Noncompliance with immunosuppressant therapy is a serious problem that leads to the possibility of graft rejection, even in the long term after liver transplantation. The objectives of the present study were to review and describe features of patient noncompliance after living-donor liver transplantation (LDLT).
  
  
  METHODS
  Among pediatric patients (age <18 years) surviving more than 5 years after LDLT, noncompliant patients were identified, and their clinicopathologic characteristics were studied retrospectively.
  
  
  RESULTS
  Of 108 pediatric recipients who survived more than 5 years after LDLT, 6 female patients (5.6%) were noncompliant. Median (range) age at transplantation was 5 (2-15) years, and at noncompliance was 18 (9-21) years. Median time to noncompliance after transplantation was 8 (5-16) years. The 6 noncompliant patients received increased immunosuppression therapy, and liver function test results improved. Noncompliance was improved via intervention with medication, but recurred in 2 patients (33%). Noncompliance did not result in graft or patient loss.
  
  
  CONCLUSIONS
  The prevalence of noncompliance was not so high in LDLT recipients. Liver dysfunction secondary to noncompliance improved with increased immunosuppression therapy.
authors.affiliation: Division of Transplantation, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Masuda
authors.forename: A
authors.initials: A
authors.lastname: Mita
authors.forename: Y
authors.initials: Y
authors.lastname: Ohno
authors.forename: K
authors.initials: K
authors.lastname: Urata
authors.forename: Y
authors.initials: Y
authors.lastname: Nakazawa
authors.forename: T
authors.initials: T
authors.lastname: Ikegami
authors.forename: T
authors.initials: T
authors.lastname: Masaru
authors.forename: S
authors.initials: S
authors.lastname: Miyagawa
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016031:Liver Transplantation; D019520:Living Donors; D010349:Patient Compliance; D012189:Retrospective Studies
chemical_list: D007166:Immunosuppressive Agents