Study pursues long-term kidney transplant patients

The University Hospital kidney transplant team and a researcher at the University of Missouri-Columbia Sinclair School of Nursing in Columbia, MO, are looking at ways to help kidney transplant recipients keep their new organ longer.

Cindy Russell, an assistant professor and researcher at the MU Sinclair School of Nursing, and a six-member team are beginning a three-year study on how kidney transplant patients take their medicine.

Her research will look at the habits of people taking post-transplantation drugs, in particular those that suppress the body’s immune system. This keeps the newly implanted kidney from being attacked by the body, but immunosuppressant drugs also make the body more prone to infections. Patients are given other medication to defend against this.

“They’re at high risk for having trouble with their medication because they have to take them for as long as the kidney lasts,” Russell said. The kidney can last 25 years or more.
The high price of immunosuppressant medication, about $1,500 a month, according to Russell, makes funding the maintenance of the kidney tough for many patients.

Medicare will pay the medication costs for those who are already part of the program because they either have a disability or are older than 65. For patients who had a transplant but are otherwise healthy, Medicare will only cover 80 percent of their medication costs for three years.

Immunosuppressant medications can have some uncomfortable side effects. Russell said many of these drugs can cause nausea, vomiting, weight gain, abnormal hair growth and sexual dysfunction, among other symptoms.

Russell hopes her study will also show how factors other than cost and discomfort affect whether patients will take their medication. Those factors include a strong social support system for the patient, his or her confidence in taking the medication and whether he or she has depression. The knowledge will help transplant teams develop strategies to get patients to take their medications.

Two years into the study, the research team will look at the health of the transplanted kidneys to try to find how the medication has affected the health of the new organs.
Russell plans to enroll 150 University Hospital transplant patients in the study. Six have agreed to participate so far, she said.

“One of the things that we’re going to look at in our study, or that is unique about our study, is that we’re looking at people who’ve had their transplant various periods of time,” Russell said. “So, in other words, we aren’t just enrolling people once they get their transplant; we’re including the people that have had their transplant for a long time.”

(Columbia-Missourian)