Background: Immunosuppressive therapies are vital for solid organ transplant (SOT) recipients to ensure graft survival, but long-term use can lead to complications. This study aimed to comprehensively evaluate the complications associated with immunosuppressive agents across different types of major SOTs. Methods: In a retrospective cohort study using a national claims database, we analyzed adult SOT recipients who began immunosuppressive therapy from 2007 to 2018. We identified complications such as infections, acute kidney injury, hypertensive emergencies, chronic kidney disease, hypertension, diabetes, dyslipidemia, and osteoporosis. These outcomes were determined through diagnostic codes, medication usage data, and hospital or emergency department visits. Results: Among 30,997 transplants with three-year follow up, complication rates varied by transplant type. Pancreatic transplant recipients had the lowest complication rate (225.9 per 1000 patient-years), while lung transplant recipients experienced the highest rate (823.9 per 1000 patient-years). Serious infections and chronic kidney disease were most common 2 to 6 months post transplant. Other complications, like acute kidney injury, hypertensive emergencies, hypertension, diabetes, dyslipidemia, and osteoporosis, were predominantly observed in the first month. Opportunistic infections peaked between 7 months and 1 year after transplantation. Conclusions: This study emphasizes the varied complications related to immunosuppressive therapy among different SOT recipients, delineating specific timeframes for each complication and maintenance regimen.

Medication reconciliation (MR), which is widely implemented worldwide, aims to improve patient safety to reduce the medication errors during care transition. Despite its widespread use, MR has not yet been implemented in the Republic of Korea, and its effectiveness has not been studied. We aimed to evaluate the impact of a multidisciplinary MR service in older patients undergoing thoracic and cardiovascular surgery. This is a single-center, prospective, controlled, before-and-after study of adult patients taking at least one chronic oral medication. Depending on the period of each patient’s participation, they will be allocated to an intervention group or control group. Patients in the intervention group will receive multidisciplinary MR, and those in the control group will receive usual care. The primary outcome is to assess the impact of the MR service on medication discrepancies between the best possible medication history and medication orders at care transition. Secondary outcomes include the incidence rate of medication discrepancies at each transition, the discrepancy rate between the sources of information, the impact of MR on medication appropriateness index score, drug-related problems, 30-day mortality, the emergency department visit rate, readmission rate after discharge, the rate and acceptability of pharmacists’ intervention during hospitalization, and patients’ satisfaction.

Aims: Medication discrepancies during transitions of care pose substantial risks, particularly in older patients receiving complex medication regimens. Obtaining the best possible medication history (BPMH) is crucial to minimize this risk. This study aimed to evaluate the effectiveness of a pharmacist‐led BPMH using various information sources including a nationwide medication history sharing program compared to conventional interviews in a tertiary hospital setting. In addition, we identified factors contributing to medication inaccuracies.Methods: A single‐center prospective study involving older patients scheduled for thoracic surgery at a tertiary hospital was conducted. Medication histories obtained through conventional interviews during the initial assessment on admission were compared with those obtained through BPMH by pharmacist‐led interviews. Logistic regression analysis was used to identify factors associated with medication inaccuracies.Results: This study included 216 patients, a significant proportion of whom were experiencing polypharmacy. The pharmacist‐led BPMH approach demonstrated superior accuracy in documenting medication histories, with conventional methods showing inaccuracies in over 70% of the cases. Factors that significantly increased the likelihood of inaccuracies included the number of medications and number of prescribers. Nonoral and as‐needed medications are particularly prone to inaccuracies.Conclusions: Pharmacist‐led BPMH significantly improved medication history accuracy compared to conventional methods, which had inaccuracies in over 70%. It is important to be careful when obtaining BPMH for older adults, particularly those with complex medication regimens, nonoral medications, or PRN medications, to enhance patient safety and reduce medication‐related risks.Trial Registration: Clinical Trial Registry identifier: KCT-006813.