Published online Sep 24, 2015. doi: 10.5500/wjt.v5.i3.73
Peer-review started: January 30, 2015
First decision: May 14, 2015
Revised: June 13, 2015
Accepted: July 11, 2015
Article in press: July 14, 2015
Published online: September 24, 2015
Processing time: 238 Days and 7.4 Hours
Core tip: When managing individual transplant recipients, awareness of potential treatment-induced complications and pre-existing comorbidities may take precedence over excessively rigid adherence to pre-existing pathways. Potential areas of improvement are: (1) a thorough assessment of immunological and metabolic risk profile of each donor recipient; (2) screening for predictors of graft loss and early signs of antibody-mediated rejection with donor-specific antibodies, protocol biopsies and proteinuria (including close follow up of adverse effects with dose adjustments or conversions as necessary); and (3) increased awareness of the possible link between poor tolerance of a given drug at a given dose and non-adherence with the prescribed regimen.