Teens Must Take This to Heart

Heart transplant patients have higher risk of death if medication is not taken as prescribed

(RxWiki News) It is hard to get teenagers to do anything on a schedule. Taking their medications regularly following a heart transplant is no exception.

Results of a new study show that not adhering to medications after heart transplant may be a more serious problem among adolescents than previously believed.

According to the study, not taking medication after surgery was linked to various health risks.

"Take your prescription correctly."

The study was conducted by Melisa Oliva, PsyD, at the Pediatric Transplant Center, Boston Children’s Hospital, and colleagues.

The objective of the study was to find out how not adhering to prescribed medication after heart transplant affected mortality rates among teenaged patients.

"With all the advances that have been made in transplant medicine, non-adherence has become the leading cause of fatal graft rejection in adolescent patients, and it's completely avoidable," Dr. Oliva said in a press release.

The researchers looked at data from 2,070 pediatric heart transplant patients, 18 years old and younger, between 1999 and 2007.

Of these patients, 186 children who were reported to be non-adherent died within one year of receiving a heart transplant, and 61 died within two years.

Further analysis of the data revealed that the risk of death following heart transplants for adolescent patients was 26 percent within one year and 33 percent within two years.

The researchers identified certain risk factors that were associated with higher risk of death in heart transplant patients including:

  • Adolescents or, in other words, patients aged between 12 and 17 years had the highest risk
  • Medicaid insurance
  • African-American patients
  • Patients who were on ventilators or ventricular assist device support during their transplant

Overall, the results of this study showed that non-adherence to medication after transplant was associated with a significantly high risk of death after surgery.

The researchers hope that studies like these will help the early identification of such patients so they can receive counseling and other support services to prevent non-adherence.

Co-author of the study and senior researcher, Christopher Almond, MD, MPH, a cardiologist at Boston Children's Hospital, said, "For so many patients to receive a life-saving transplant—only to die from something this preventable—drives home the seriousness of this problem."

"If the medical community can use these data to better identify and counsel at-risk patients as to what the real consequences of non-adherence can be, we believe an important number of pediatric transplant deaths can be avoided going forward."

The study was published online June 4 in the Journal of Heart and Lung Transplantation.

Review Date: 
June 8, 2013