Editing Transplant rejection (section)

== Rejection due to non-adherence ==
One principal reason for transplant rejection is non-adherence to prescribed immunosuppressant regimens. This is particularly the case with adolescent recipients,<ref name="pmid22248250">{{cite journal | vauthors = Dobbels F, Hames A, Aujoulat I, Heaton N, Samyn M | title = Should we retransplant a patient who is non-adherent? A literature review and critical reflection | journal = Pediatric Transplantation | volume = 16 | issue = 1 | pages = 4–11 | date = February 2012 | pmid = 22248250 | doi = 10.1111/j.1399-3046.2011.01633.x | s2cid = 1895827 | url = https://lirias.kuleuven.be/handle/123456789/363151 | url-access = subscription }}</ref> with non-adherence rates near 50% in some instances.<ref name="pmid22248250" />

A pilot study conducted by Michael O. Killian PhD from Florida State University and Dr. Dipankar Gupta from University of Florida published in April 2022 in ''Pediatric Transplantation'' <ref>{{Cite journal |last1=Killian |first1=Michael O. |last2=Clifford |first2=Stephanie |last3=Lustria |first3=Mia Liza A. |last4=Skivington |first4=Gage L. |last5=Gupta |first5=Dipankar |date=2022-04-18 |title=Directly observed therapy to promote medication adherence in adolescent heart transplant recipients |journal=Pediatric Transplantation |volume=26 |issue=5 |pages=e14288 |language=en |doi=10.1111/petr.14288 |pmid=35436376 |s2cid=248242427 |issn=1397-3142|doi-access=free }}</ref> studied the acceptability and feasibility of an asynchronous directly observed therapy mobile health application among adolescent heart transplant recipients. Patients in the study utilized emocha Health's digital medication adherence program which included asynchronous video messages and chat messages exchanged with a care team. Patients completing the study achieved a 90.1% adherence rate. The researchers noted that further randomized trials are required to confirm the initial findings. However, the results were very promising considering few options exist to support pediatric patients in taking their medications.{{cn|date=May 2024}}