Noncompliance in renal transplant recipients: Experience in Taiwan

Patient compliance is one of the key factors of successful treatment following renal transplantation. Eleven out of 228 renal transplant recipients (4.8%) in our series displayed evidence of medical noncompliance which happened after the recipients had enjoyed good graft function for an average of 53.1 ± 16.9 months after transplantation. In comparison with the control group, these recipients were usually younger (26.3 ± 5.49 VS 32.6 ± 8.92 years old, p < 0.05), had fewer rejection episodes (0% VS 21.4%, p < 0.05) and had lower educational level (p < 0.01). Nine of these noncompliant patients (81.8%) lost their kidney grafts eventually. Three of them died from complications after kidney graft failure. Noncompliance was responsible for 21.4% of total graft loss, the third leading cause of graft loss after rejection (50.0%) and infection (26.2%). Since there is a severe shortage of donor kidneys in the Taiwan area, great effort much be spent to prevent kidney graft loss from patient noncompliance. Patient education and alertness to the risk factors of noncompliance should be emphasized.