Emergency but Not for Everyone: The Transplant Medication Gap in the Emergency Department

Document Type

Conference Proceeding

Publication Date

3-6-2026

Publication Title

Am J Health Syst Pharm

Keywords

Pharmacology & Pharmacy

Abstract

Purpose: The highly demanding environment of the emergency department (ED) makes it challenging to accurately review and manage outpatient medication regimens. This is especially critical for solid organ transplant (SOT) recipients, whose care involves frequent immunosuppressive adjustments, management of comorbidities, and/or infectious prophylaxis. Inadequate medication management may increase the risk of infection, graft failure, and mortality for SOT recipients. However, limited data exists on how transplant-related medications are utilized in the ED. This medication-use evaluation aims to describe transplant-related medication practice in the ED at Henry Ford Hospital in Detroit. Methods: This retrospective medication use evaluation will describe the utilization of pre-admission transplant-related medications in the ED at Henry Ford Hospital, Detroit between January 1st, 2025, and August 31st, 2025. Patients with a history of SOT within the past 5 years, presenting to the ED with prior to admission transplant-related maintenance therapy that includes immunosuppressive and/or prophylactic medications will be included. Patients who are pregnant, incarcerated, cognitively impaired, or have an ED visit lasting less than eight hours without any transplant-related medications prescribed or administered will be excluded. The primary outcome is to evaluate ED practice patterns for transplant-related medications by comparing prior to admission therapy with medications administered, or not administered, in the ED. This will be accomplished by determining appropriateness of transplant-related medication administration in the ED. Secondary outcomes include time to restart transplant-related medications in the ED, documentation of I-vent placed in patient’s chart, presence of a transplant consult during ED visit, potential indications to withhold transplant related medications, and ED length of stay. Key baseline demographics includes ethnicity, transplant type, time since transplantation, and presence of infection in the ED. Data will be analyzed using measures of central tendency with mean with standard deviation or median with interquartile range, where appropriate. This study has been submitted to the IRB and is awaiting approval.

Volume

83

First Page

S801

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