Disruptions in the supply of medications used in transplantation: Implications and management strategies for the transplant clinician

Abstract

Drug shortages are a threat to patient care and public health, and the number of drugs on shortage is growing at an exponential rate. The major therapy areas affected by these shortages are oncology, anti-infective, cardiovascular and central nervous system. However, drugs utilized in the transplant patient population have not been exempt, and can have significant influence on posttransplant outcomes. The purpose of this review is to discuss the current and historical solid organ transplant-related disruptions in the supply of medications and implications on patient care and safety. Transplant centers should be armed with an implementation plan when imperative transplant-related drugs such as tacrolimus, mycophenolate, or antithymocyte globulin go on shortage. This plan should provide steps to manage the shortage, and provide effective therapeutic alternatives. This review discusses the incidence and impact of drug shortages in solid organ transplantation and provides recommendations for transplant clinicians on appropriate therapeutic and global management of these shortages. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.