Low participation in preventative health measures in a cohort of liver transplant recipients: A cross-sectional analysis.

Abstract

Despite high rates of infection and malignancy post-solid organ transplant, there are little data on patient participation in preventative health care. We conducted a cross-sectional survey of post-liver transplant patients to evaluate insight into transplant-associated infective and neoplastic risks, and receipt of vaccination and cancer surveillance in accordance with Australian and local institution-specific guidelines. Descriptive analyses were used to assess characteristics potentially influencing adherence. Of 219 patients surveyed, adherence to bowel cancer surveillance was significantly reduced in those distant from transplantation compared with those recently transplanted (95.8% if transplanted≤5years ago vs. 68.3% if transplanted>5years ago, P<.001). Skin cancer surveillance participation with annual physician-directed examination was low (42.9%), particularly in younger patients (29.5% in<50yo vs. 48.1% in≥50yo, P=.01), who were also less adherent to vaccination recommendations (72.1% in<50yo vs. 87.3% in≥50yo, P=.008). This is the first analysis of preventative healthcare participation in a cohort of Australian liver transplant recipients, revealing concerning adherence to bowel and skin cancer surveillance recommendations. Major interventions to avoid preventable disease in this high-risk cohort are warranted.