Skip to main content

Advertisement

SpringerLink
Log in

Using Technology to Facilitate Monitoring of Transplant Patients

  • Liver Transplantation (DC Mulligan and R Batra, Section Editor)
  • Published:
Current Transplantation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Health information technology (HIT) has emerged as an invaluable tool in the care of transplant patients. In this review, the recent developments in technology and monitoring of transplant patients are described.

Recent Findings

HIT in the form of electronic medical records (EMR) has played a significant role in the care and monitoring of transplant patients to date. However, with the relatively recent adoption of personal smart mobile phones and devices, the utilization of mobile health (mHealth), telemedicine, and electronic alert systems has transformed the care of transplant patients. Technology in transplant patient monitoring has been shown to improve patient outcomes by increasing medication adherence, improving patient satisfaction and quality of life, and by decreasing cost of care.

Summary

Recent literature has shown the benefit of technology in the care and monitoring of transplant patients. As the prevalence and affordability of these technologies increase, larger studies examining the impact of HIT on long-term outcomes of transplant patients will be useful in promoting the widespread use of this valuable resource.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. • Levine D, Torabi J, Choinski K, Rocca JP, et al. Transplant surgery enters a new era: Increasing immunosuppressive medication adherence through mobile apps and smart watches. Am J Surg. 2019;218:18–20. This study employed the use of a mobile app (Transplant Hero) to evaluate effect on immunosuppression medication adherence. Kidney transplant recipients were randomized to receive the mobile app, both the mobile app and smart watch, or neither. Interestingly, there was no difference in adherence (measured by coefficient of variability) between the groups at one or three months.

    Article  Google Scholar 

  2. Niazkhani Z, Pirnejad H, Rashidi Khazaee P. The impact of health information technology on organ transplant care: a systematic review. Int J Med Inform. 2017;100:95–107.

    Article  Google Scholar 

  3. • Fleming JN, Taber DJ, McElligott J, McGillicuddy JW, et al. Mobile health in solid organ transplant: the time is now. Am J Transplant. 2017;17:2263–76. Provides a concise review of evidence up to 2017 on the status of mobile health (mHealth) in solid organ transplantation.

    Article  CAS  Google Scholar 

  4. Pondrom S. The AJT report: news and issues that affect organ and tissue transplantation. Missing the mark: hospital-wide electronic medical record systems don’t always accommodate transplantation’s specific needs. Am J Transplant. 2012;12:1–2.

    Article  Google Scholar 

  5. Park ES, Peccoud MR, Wicks KA, Halldorson JB, et al. Use of an automated clinical management system improves outpatient immunosuppressive care following liver transplantation. J Am Med Inform Assoc. 2010;17:396–402.

    Article  Google Scholar 

  6. • Lee TC, Kaiser TE, Alloway R, Woodle ES, et al. Telemedicine based remote home monitoring after liver transplantation: results of a randomized prospective trial. Ann Surg. 2019;270:564–72. This randomized controlled trial examined the impact of a telemedicine-based home management program (THP) on patient outcomes following liver transplantation. Liver transplant recipients were randomized to either THMP or standard of care (SOC) groups. The THMP cohort showed lower 90-day readmission rate and improved quality of life at 90 days.

    Article  Google Scholar 

  7. Organization WH. mHealth: new horizons for health through mobile technologies: second global survey on eHealth. Available at: https://www.who.int/goe/publications/goe_mhealth_web.pdf. Accessed April 16, 2021.

  8. Kuypers DRJ. From nonadherence to adherence. Transplantation. 2020;104:1330–40.

    Article  Google Scholar 

  9. Ertel AE, Kaiser T, Shah SA. Using telehealth to enable patient-centered care for liver transplantation. JAMA Surg. 2015;150:674–5.

    Article  Google Scholar 

  10. Triplett KN, El-Behadli AF, Masood SS, Sullivan S, et al. Digital medicine program with pediatric solid organ transplant patients: perceived benefits and challenges. Pediatr Transplant. 2019;23:e13555.

    Article  Google Scholar 

  11. Browning RB, McGillicuddy JW, Treiber FA, Taber DJ. Kidney transplant recipients’ attitudes about using mobile health technology for managing and monitoring medication therapy. J Am Pharm Assoc (2003). 2016;56:450–4 e1.

    Article  Google Scholar 

  12. McGillicuddy JW, Weiland AK, Frenzel RM, Mueller M, et al. Patient attitudes toward mobile phone-based health monitoring: questionnaire study among kidney transplant recipients. J Med Internet Res. 2013;15:e6.

    Article  Google Scholar 

  13. Jiang Y, Sereika SM, Dabbs AD, Handler SM, et al. Acceptance and use of mobile technology for health self-monitoring in lung transplant recipients during the first year post-transplantation. Appl Clin Inform. 2016;7:430–45.

    Article  Google Scholar 

  14. Wu C, Shah N, Sood P, Puttarajappa C, Bernardo J, Mehta R, et al. Use of the electonric health record (EHR) to improve the pre-transpalnt process for kidney and pancreas transplnation. Transplantion. 2014;98:833–4.

    Article  Google Scholar 

  15. Gordon EJ, Sohn MW, Chang CH, McNatt G, et al. Effect of a mobile web app on kidney transplant candidates’ knowledge about increased risk donor kidneys: a randomized controlled trial. Transplantation. 2017;101:1167–76.

    Article  Google Scholar 

  16. Manickavasagar R, Wong G, Alexander SI, Francis A, et al. Allograft outcome following repeat transplantation of patients with non-adherence-related first kidney allograft failure: a population cohort study. Transpl Int. 2019;32:1247–58.

    Article  Google Scholar 

  17. Cherukuri A, Mehta R, Sharma A, Sood P, et al. Post-transplant donor specific antibody is associated with poor kidney transplant outcomes only when combined with both T-cell-mediated rejection and non-adherence. Kidney Int. 2019;96:202–13.

    Article  CAS  Google Scholar 

  18. McGillicuddy JW, Gregoski MJ, Weiland AK, Rock RA, et al. Mobile health medication adherence and blood pressure control in renal transplant recipients: a proof-of-concept randomized controlled trial. JMIR Res Protoc. 2013;2:e32.

    Article  Google Scholar 

  19. Ganjali R, Taherzadeh Z, Ghorban Sabbagh M, Nazemiyan F, et al. Effect of an interactive voice response system on self-management in kidney transplant recipients: protocol for a randomized controlled trial. Medicine (Baltimore). 2019;98:e14291.

    Article  Google Scholar 

  20. Mansell H, Rosaasen N, West-Thielke P, Wichart J, et al. Randomised controlled trial of a video intervention and behaviour contract to improve medication adherence after renal transplantation: the VECTOR study protocol. BMJ Open. 2019;9:e025495.

    Article  Google Scholar 

  21. Russell CL, Hathaway D, Remy LM, Aholt D, et al. Improving medication adherence and outcomes in adult kidney transplant patients using a personal systems approach: SystemCHANGE results of the MAGIC randomized clinical trial. Am J Transplant. 2020;20:125–36. Although this article did not center around technology in the care of transplant patients, this behavior-based intervention (SystemCHANGE™) did effectively increase immunosuppressive medication adherence when compared to attention control. This article highlights the role of behavior education and coaching in the role of medication adherence.

    Article  CAS  Google Scholar 

  22. Geramita EM, DeVito Dabbs AJ, DiMartini AF, Pilewski JM, et al. Impact of a mobile health intervention on long-term nonadherence after lung transplantation: follow-up after a randomized controlled trial. Transplantation. 2020;104:640–51.

    Article  Google Scholar 

  23. Eisenberger U, Wuthrich RP, Bock A, Ambuhl P, et al. Medication adherence assessment: high accuracy of the new Ingestible Sensor System in kidney transplants. Transplantation. 2013;96:245–50.

    Article  Google Scholar 

  24. McKenzie RB, Berquist WE, Foley MA, Park KT, et al. Text messaging improves participation in laboratory testing in adolescent liver transplant patients. J Particip Med. 2015;7.

  25. DeVito DA, Song MK, Myers BA, Li R, et al. A randomized controlled trial of a mobile health intervention to promote self-management after lung transplantation. Am J Transplant. 2016;16:2172–80.

    Article  Google Scholar 

  26. Reese PP, Bloom RD, Trofe-Clark J, Mussell A, et al. Automated reminders and physician notification to promote immunosuppression adherence among kidney transplant recipients: a randomized trial. Am J Kidney Dis. 2017;69:400–9.

    Article  Google Scholar 

  27. Eno AK, Ruck JM, Van Pilsum Rasmussen SE, Waldram MM, et al. Perspectives on implementing mobile health technology for living kidney donor follow-up: in-depth interviews with transplant providers. Clin Transpl. 2019;33:e13637.

    Article  Google Scholar 

  28. Richards VL, Johnson CK, Blosser CD, Sibulesky L. Strategies to improve patient engagement in young kidney transplant recipients: a review. Ann Transplant. 2018;23:654–8.

    Article  Google Scholar 

  29. Forbes RC, Rybacki DB, Johnson TB, Hannah-Gillis A, et al. A cost comparison for telehealth utilization in the kidney transplant waitlist evaluation process. Transplantation. 2018;102:279–83.

    Article  Google Scholar 

  30. Sidhu A, Chaparro C, Chow CW, Davies M, et al. Outcomes of telehealth care for lung transplant recipients. Clin Transpl. 2019;33:e13580.

    Article  Google Scholar 

  31. • Schenkel FA, Barr ML, McCloskey CC, Possemato T, et al. Use of a Bluetooth tablet-based technology to improve outcomes in lung transplantation: A pilot study. Am J Transplant. 2020;20:3649–57. This observational pilot study enrolled 28 lung transplant recipients in a post-discharge home monitoring program utilizing Bluetooth technology and compared several endpoints related to outcome to 28 matched controls over a 2-year period following transplant. Bluetooth monitoring was found to be associated with reduced readmissions, days readmitted, and hospital charges.

    Article  Google Scholar 

  32. Rudin RS, Bates DW, MacRae C. Accelerating innovation in health IT. N Engl J Med. 2016;375:815–7.

    Article  Google Scholar 

  33. McElroy I, Sareh S, Zhu A, Miranda G, et al. Use of digital health kits to reduce readmission after cardiac surgery. J Surg Res. 2016;204:1–7.

    Article  Google Scholar 

Download references

Availability of Data and Material

All data obtained from published works available on pubmed.gov.

Author information

Authors and Affiliations

  1. Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, ML, Cincinnati, OH, 0558, USA

    Allison M. Ammann, Aaron M. Delman & Shimul A. Shah

  2. Cincinnati Research on Outcomes and Safety in Surgery (CROSS) Research Group, The Department of Surgery at The University of Cincinnati, Cincinnati, OH, USA

    Allison M. Ammann, Aaron M. Delman & Shimul A. Shah

Authors
  1. Allison M. Ammann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aaron M. Delman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shimul A. Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shimul A. Shah.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Liver Transplantation

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ammann, A.M., Delman, A.M. & Shah, S.A. Using Technology to Facilitate Monitoring of Transplant Patients. Curr Transpl Rep 8, 228–234 (2021). https://doi.org/10.1007/s40472-021-00332-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40472-021-00332-3

Keywords

Search

Navigation