CLINICAL PHARMACIST IN A MULTIDISCIPLINARY TRANSPLANT TEAM: CURRENT TRENDS IN PROFESSIONAL ACTIVITY
DOI:
https://doi.org/10.11603/2312-0967.2026.1.15993Keywords:
clinical pharmacist, multidisciplinary team, organ transplantation, immunosuppressive therapy, pharmacotherapyAbstract
The aim of the work. Based on a critical analysis of current global scientific literature and regulatory requirements, to theoretically substantiate and structure the main vectors of the professional activity of a clinical pharmacist as a key link within a multidisciplinary transplant team.
Materials and Methods. Scientific publications (articles and systematic reviews), results of randomized clinical, cohort, retrospective, prospective, and ambispective studies, as well as regulatory documents pertaining to the activities of a clinical pharmacist within a multidisciplinary transplant team. Bibliosemantic, analytical, comparative, and systemic methods were used to study the current scientific base for the activities of clinical pharmacist in the field of transplantation.
Results and Discussion. Based on the analysis of scientific literature, the vectors of professional activity for a clinical pharmacist within a multidisciplinary transplant team have been structured. These include impact on: clinical and economic outcomes, length of hospital stay, and readmission rates; post-transplantation immunosuppressive therapy; prevention and treatment of cytomegalovirus infection; educational interventions by the clinical pharmacist; and activities within collaborative practice agreements. The clinical pharmacist's interventions were categorized into three stages: pre-transplantation, peri-transplantation, and post-transplantation, as well as in outpatient settings.
Conclusions. The activities of a clinical pharmacist within a multidisciplinary team positively impacts the therapeutic and clinical efficacy of transplantation, yields significant economic benefits, facilitates individualized pharmacotherapy plans, and provides educational support for post-transplant patients, thereby increasing their adherence to immunosuppressive therapy. The integration of a clinical pharmacist into a multidisciplinary transplant team ensures a systematic approach to interventions across all stages of transplantation, addressing the specificities of each phase, and leadsnto the expantion of professional competencies through then establishment of collaborative practice agreements.
References
Transplantatsiya: za 2025 rik ukrayinsʹki medyky vykonaly ponad 650 orhannykh peresadok – pidsumky [Transplantation: in 2025, Ukrainian doctors performed more than 650 organ transplants - results]. MOZ Ukrayiny. URL: https://moz.gov.ua/uk/transplantaciya-za-2025-rik-ukrayinski-mediki-vikonali-ponad-650-organnih-peresadok-pidsumki
Sʹohodni – Vsesvitniy denʹ donorstva ta transplantatsiyi orhaniv [Today is World Organ Donation and Transplantation Day]. Sayt Ukrayinsʹkyy tsentr transplant-koordynatsiyi. 17.10.2023 r. URL: https://utcc.gov.ua/sogodni-vsesvitnij-den-donorstva-ta-transplantatsiyi-organiv/
The Role of Multidisciplinary Teams in Transplant Success. URL: https://housemedicine.com/the-role-of-multidisciplinary-teams-in-transplant-success/
Sam S, Guérin A, Rieutord A, Belaiche S, Bussières JF. Roles and Impacts of the Transplant Pharmacist: A Systematic Review. Can J Hosp Pharm. 2018 Sep-Oct;71(5):324-37. Epub 2018 Oct 31. URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC6209508/#b4-cjhp-71-324 DOI: https://doi.org/10.4212/cjhp.v71i5.2843
Mitchell JF. Pharmacist involvement as a member of a renal transplant team. Am J Hosp Pharm. 1976;33(1):55-8. URL: https://pubmed.ncbi.nlm.nih.gov/773178/ DOI: https://doi.org/10.1093/ajhp/33.1.55
Ciminelli AM, Dupuis R, Williams D, Hollar K, Fair JH, Johnson M, Gerber D. Patient education role of a pharmacist on a transplant service. Am J Health Syst Pharm. 2000 Apr 15;57(8):767-8. doi: 10.1093/ajhp/57.8.767. DOI: https://doi.org/10.1093/ajhp/57.8.767
Chisholm-Burns MA, Spivey CA, Garrett C, McGinty H, Mulloy LL. Impact of clinical pharmacy services on renal transplant recipients' adherence and outcomes. Patient Prefer Adherence. 2008 Feb 2;2:287-92. doi: 10.2147/ppa.s4174. DOI: https://doi.org/10.2147/PPA.S4174
Klein A, Otto G, Krämer I. Impact of a pharmaceutical care program on liver transplant patients' compliance with immunosuppressive medication: a prospective, randomized, controlled trial using electronic monitoring. Transplantation. 2009 Mar 27;87(6):839-47. doi: 10.1097/TP.0b013e318199d122. DOI: https://doi.org/10.1097/TP.0b013e318199d122
Hlubocky JM, Stuckey LJ, Schuman AD, Stevenson JG. Evaluation of a transplantation specialty pharmacy program. Am J Health Syst Pharm. 2012 Feb 15;69(4):340-7. doi: 10.2146/ajhp110350. PMID: 22302259. DOI: https://doi.org/10.2146/ajhp110350
Maldonado AQ, Weeks DL, Bitterman AN, McCleary JA, Seiger TC, Carson RW, Tabon PK, Goroski AL, Ojogho ON. Changing transplant recipient education and inpatient transplant pharmacy practices: a single-center perspective. Am J Health Syst Pharm. 2013 May 15;70(10):900-4. doi: 10.2146/ajhp120254. DOI: https://doi.org/10.2146/ajhp120254
Taber DJ, Pilch NA, Trofe-Clark J, Kaiser TE. A National Survey Assessing the Current Workforce of Transplant Pharmacists Across Accredited U.S. Solid Organ Transplant Programs. Am J Transplant. 2015;15(10):2683-90. doi:10.1111/ajt.13323. DOI: https://doi.org/10.1111/ajt.13323
Wiegel JJ, Olyaei AJ. The role of the pharmacist in the management of kidney transplant recipients. Indian J Urol. 2016;32(3):192-8. doi:10.4103/0970-1591.185108. DOI: https://doi.org/10.4103/0970-1591.185108
Alloway RR, Dupuis R, Gabardi S, Kaiser TE, Taber DJ, Tichy EM, Weimert-Pilch NA; American Society of Transplantation Transplant Pharmacy Community of Practice and the American College of Clinical Pharmacy Immunology/Transplantation Practice and Research Network. Evolution of the role of the transplant pharmacist on the multidisciplinary transplant team. Am J Transplant. 2011 Aug;11(8):1576-83. doi: 10.1111/j.1600-6143.2011.03601.x. Epub 2011 Jun 14. DOI: https://doi.org/10.1111/j.1600-6143.2011.03601.x
Angela Q Maldonado, Reed C Hall, Nicole A Pilch, Christopher R Ensor, Stephanie Anders, Jennifer A Gilarde, Eric M Tichy, ASHP Guidelines on Pharmacy Services in Solid Organ Transplantation, American Journal of Health-System Pharmacy. 2020;77(3):222-32. DOI: 10.1093/ajhp/zxz291 DOI: https://doi.org/10.1093/ajhp/zxz291
Staino C, Lewin JJ 3rd, Nesbit TW, Sullivan B, Ensor CR. Survey of transplant-related pharmacy services at large comprehensive transplant centers in the United States. Prog Transplant. 2013;23(1):23-7. doi:10.7182/pit2013519 DOI: https://doi.org/10.7182/pit2013519
Yang H, Li L, Hu X, Wang W, Yang X, Liu H, Ren L, Zhang X, Liu L. Impact of pharmacist-led post-transplant medication management for kidney transplant recipients: A retrospective pre- and post-intervention study. J Clin Pharm Ther. 2019 Aug;44(4):603-10. doi: 10.1111/jcpt.12826. DOI: https://doi.org/10.1111/jcpt.12826
Ah YM Lee JY, Moon MR, Cho YS, Kim HS, Yi NJ, Lee KW, Suh KS. Clinical and economic evaluation of pharmacists' contribution to patient care on a multi-disciplinary liver transplant team. Int J Clin Pharmacol Ther. 2016 Feb;54(2):102-9. doi: 10.5414/CP202501. DOI: https://doi.org/10.5414/CP202501
Lima LF, Martins BC, Oliveira FR, Cavalcante RM, Magalhães VP, Firmino PY, Adriano LS, Silva AM, Flor MJ, Néri ED. Pharmaceutical orientation at hospital discharge of transplant patients: strategy for patient safety. Einstein (Sao Paulo). 2016 Jul-Sep;14(3):359-65. doi: 10.1590/S1679-45082016AO3481. DOI: https://doi.org/10.1590/S1679-45082016AO3481
Shawaqfeh MS; Alangari D; Aldamegh G; Almotairi J; Bin Orayer L; Albekairy NA; Abdel-Razaq W; Mardawi G; Almuqbil F; Aldebasi TM; et al. Unveiling medication errors in liver transplant patients towards enhancing the imperative patient safety. Saudi Pharm. J. 2023; 31,101789. doi: 10.1016/j.jsps.2023.101789. DOI: https://doi.org/10.1016/j.jsps.2023.101789
Mulder MB; Doga B; Borgsteede SD; van den Burg, AM; Metselaar HJ; den Hoed CM; Hunfeld NGM. Evaluation of medication-related problems in liver transplant recipients with and without an outpatient medication consultation by a clinical pharmacist: A cohort study. Int. J. Clin. Pharm. 2022;44:1114-22. doi: 10.1007/s11096-022-01423-6. DOI: https://doi.org/10.1007/s11096-022-01423-6
Duwez M, Chanoine S, Lepelley M, Vo TH, Pluchart H, Mazet R, Allenet B, Pison C, Briault A, Saint-Raymond C, Camara B, Claustre J, Bedouch P. Clinical evaluation of pharmacists' interventions on multidisciplinary lung transplant outpatients' management: results of a 7-year observational study. BMJ Open. 2020 Nov 27;10(11):e041563. doi: 10.1136/bmjopen-2020-041563. DOI: https://doi.org/10.1136/bmjopen-2020-041563
Alsheikh R, Johnson K, Dauenhauer A, Kadambi P. Impact of transplant pharmacists on length of stay and 30-day hospital readmission rate: a single-centre retrospective cohort study. Eur J Hosp Pharm. 2021;28(Suppl 2):e146-e150. doi:10.1136/ejhpharm-2020-002421 DOI: https://doi.org/10.1136/ejhpharm-2020-002421
Jamieson NJ, Hanson CS, Josephson MA, Gordon EJ, Craig JC, Halleck F, Budde K, Tong A. Motivations, Challenges, and Attitudes to Self-management in Kidney Transplant Recipients: A Systematic Review of Qualitative Studies. Am J Kidney Dis. 2016 Mar;67(3):461-78. doi: 10.1053/j.ajkd.2015.07.030. DOI: https://doi.org/10.1053/j.ajkd.2015.07.030
Rostaing L. Suchasnyy protokol imunosupresiyi pry transplantatsiyi nyrok [Modern immunosuppression protocol for kidney transplantation]. Spetsializovanyy medychnyy portal Health-ua.com, 23 lyutoho 2021 r. URL: https://health-ua.com/nephrology/transplantologiia/63759-suchasnij-protokol-munosupres-pritransplantatc-nirok
Süsal C, Döhler B. Late intra‐patient tacrolimus trough level variability as a major problem in kidney transplantation: a collaborative transplant study report. Am J Transplant. 2019;19(10):2805-13. doi: 10.1111/ajt.15346 DOI: https://doi.org/10.1111/ajt.15346
Schuh MJ, Massoglia G. Pharmacist Impact on Tacrolimus Serum Concentrations in Liver Transplant Patients. Consult Pharm. 2018;33(5):268-72. doi:10.4140/TCP.n.2018.268. DOI: https://doi.org/10.4140/TCP.n.2018.268.
Gantar K, Škerget K, Mochkin I, Bajc A. Meeting Regulatory Requirements for Drugs with a Narrow Therapeutic Index: Bioequivalence Studies of Generic Once-Daily Tacrolimus. Drug Healthc Patient Saf. 2020;12:151-60. doi: 10.2147/DHPS.S256455. DOI: https://doi.org/10.2147/DHPS.S256455
Schütte-Nütgen K, Thölking G, Suwelack B, Reuter S. Tacrolimus-Pharmacokinetic Considerations for Clinicians. Curr. Drug Metab. 2018;19:342-50. doi: 10.2174/1389200219666180101104159. DOI: https://doi.org/10.2174/1389200219666180101104159
Thölking G, Schütte-Nütgen K, Schmitz J, Rovas A, Dahmen M, Bautz J, Jehn U, Pavenstädt H, Heitplatz B, Van Marck V, Suwelack B, Reuter S. A Low Tacrolimus Concentration/Dose Ratio Increases the Risk for the Development of Acute Calcineurin Inhibitor-Induced Nephrotoxicity. J Clin Med. 2019 Oct 2;8(10):1586. doi: 10.3390/jcm8101586. DOI: https://doi.org/10.3390/jcm8101586
Naesens M, Kuypers DR, Sarwal M. Calcineurin inhibitor nephrotoxicity. Clin. J. Am. Soc. Nephrol. 2009;4:481-508. doi: 10.2215/CJN.04800908. DOI: https://doi.org/10.2215/CJN.04800908
Griffin SP, Nelson JE. Impact of a Clinical Solid Organ Transplant Pharmacist on Tacrolimus Nephrotoxicity, Therapeutic Drug Monitoring, and Institutional Revenue Generation in Adult Kidney Transplant Recipients. Prog Transplant. 2016;26(4):314-21. doi:10.1177/1526924816667950 DOI: https://doi.org/10.1177/1526924816667950
Massoglia G, Ramnarine M, Schuh MJ. Tacrolimus Therapeutic Drug Monitoring in Kidney Transplant Patients Before and After Pharmacist Post-transplant Consults. Innov Pharm. 2021;12(3):10.24926/iip.v12i3.4212. Published 2021 Jun 10. doi:10.24926/iip.v12i3.4212 DOI: https://doi.org/10.24926/iip.v12i3.4212
Lhermitte R, Le Daré B, Laval F, Lemaitre F, Troussier B, Morin MP, Vigneau C, Chemouny JM, Bacle A. A pharmacist-led intervention to improve kidney transplant recipient outcomes and identify patients at risk of highly variable trough tacrolimus levels: a cohort study. Eur J Hosp Pharm. 2024 Jun 21;31(4):314-20. doi: 10.1136/ejhpharm-2022-003625 DOI: https://doi.org/10.1136/ejhpharm-2022-003625
Thrall SA, Fominaya CE, Chiasson JM, Castle S, Taber DJ. Improvement in immunosuppression therapy monitoring in organ transplant recipients. Am J Health Syst Pharm. 2017;74(17 Supplement 3):S67-S74. doi:10.2146/ajhp160872 DOI: https://doi.org/10.2146/ajhp160872
Jibai N, Koch A, Ulmer TF, Erdmann P, Koeck JA, Eisert A. Pharmaceutical Interventions for Inpatients with Liver Cirrhosis and Liver Transplantation: A Systematic Review of Experimental Studies. J Clin Med. 2023;12(22):7030. Published 2023 Nov 10. doi:10.3390/jcm12227030. DOI: https://doi.org/10.3390/jcm12227030
Razonable RR. Cytomegalovirus in Solid Organ Transplant Recipients: Clinical Updates, Challenges and Future Directions. Curr Pharm Des. 2020;26(28):3497-506. doi: 10.2174/1381612826666200531152901. DOI: https://doi.org/10.2174/1381612826666200531152901
Byrns JS, Pilch NW, Taber DJ. Impact of Pharmacist Involvement in Early Identification and Enrollment in Patient Assistance Programs on CMV Outcomes in Transplantation. J Pharm Pract. 2016 Apr;29(2):97-102. doi: 10.1177/0897190014544788. DOI: https://doi.org/10.1177/0897190014544788
Wang N, Athans V, Neuner E, Bollinger J, Spinner M, Brizendine K. A pharmacist-driven antimicrobial stewardship intervention targeting cytomegalovirus viremia in ambulatory solid organ transplant recipients. Transpl Infect Dis. 2018;20(6):e12991. doi:10.1111/tid.12991 DOI: https://doi.org/10.1111/tid.12991
Chambord J, Couzi L, Merville P, Moreau K, Xuereb F, Djabarouti S. Benefit of a pharmacist-led intervention for medication management of renal transplant patients: a controlled before-and-after study. Ther Adv Chronic Dis. 2021 Apr 5;12:20406223211005275. doi: 10.1177/20406223211005275. DOI: https://doi.org/10.1177/20406223211005275
Khorassani F, Tellier S, Tsapepas D. Pharmacist's Role in Improving Medication Adherence in Transplant Recipients With Comorbid Psychiatric Disorders. J Pharm Pract. 2019;32(5):568-78. doi:10.1177/0897190018764074. DOI: https://doi.org/10.1177/0897190018764074
Rodriguez KE, Chelewski RJ, Peter ME, Zuckerman AD, Choi L, DeClercq J, Langone A. Integrating pharmacists into a kidney transplant clinic: Developing and implementing a collaborative pharmacy practice agreement. J Am Pharm Assoc (2003). 2022 Jan-Feb;62(1):349-56. doi: 10.1016/j.japh.2021.07.004. DOI: https://doi.org/10.1016/j.japh.2021.07.004
Chelewski R, Rodriguez K, Peter M, Zuckerman A. Assessing Pharmacist Interventions at an Outpatient Renal Transplant Clinic Under a Collaborative Pharmacy Practice Agreement. Journal of Pharmacy Practice. 2023;37(3):593-9. doi:10.1177/08971900221149544 DOI: https://doi.org/10.1177/08971900221149544
Gonzales HM, Fleming JN, Gebregziabher M, Posadas-Salas MA, Su Z, McGillicuddy JW, Taber DJ. Pharmacist-Led Mobile Health Intervention and Transplant Medication Safety: A Randomized Controlled Clinical Trial. Clin J Am Soc Nephrol. 2021 May 8;16(5):776-84. doi: 10.2215/CJN.15911020. DOI: https://doi.org/10.2215/CJN.15911020
Taber DJ, Fleming JN, Su Z, Mauldin P, McGillicuddy JW, Posadas A, Gebregziabher M. Significant hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients. Am J Transplant. 2021 Oct;21(10):3428-35. doi: 10.1111/ajt.16737. DOI: https://doi.org/10.1111/ajt.16737
Fleming JN, Gebregziabher M, Posadas A, Su Z, McGillicuddy JW, Taber DJ. Impact of a pharmacist-led, mHealth-based intervention on tacrolimus trough variability in kidney transplant recipients: A report from the TRANSAFE Rx randomized controlled trial. Am J Health Syst Pharm. 2021 Jul 9;78(14):1287-93. doi: 10.1093/ajhp/zxab157. DOI: https://doi.org/10.1093/ajhp/zxab157
Jandovitz N, Li H, Watts B, Monteiro J, Kohlberg D, Tsapepas D. Telemedicine pharmacy services implementation in organ transplantation at a metropolitan academic medical center. Digit Health. 2018 Jul 26;4:2055207618789322. doi: 10.1177/2055207618789322. DOI: https://doi.org/10.1177/2055207618789322
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