Solid Organ Transplant Pharmacy – The Road to BCTXP

Over the past two decades, there has been tremendous growth in the field of solid organ transplantation (SOT), especially within the pharmacy profession. Pharmacist involvement in solid organ transplant recipient care was described as early as the 1970s.^1,2 In 2004, the United Network for Organ Sharing (UNOS) amended their bylaws to mandate the inclusion of a transplant pharmacist on the multidisciplinary team.³ UNOS also designated the roles and responsibilities of the SOT pharmacist including the oversight of transplant pharmacotherapy in the peri- and post-operative phases. In 2007, the American Society of Health-System Pharmacists established goals, objectives, and competencies for specialized SOT pharmacist residency training, which was further updated in 2017.⁴

SOT pharmacists are familiar with the challenge of optimizing care for a patient who spans the continuum of care – from the ambulatory setting to the operating room and the intensive care unit.^5,6 Care delivery is further complicated as transplants occur across all age groups and in patients with varying comorbid conditions. This complex comorbid condition management, including need for immunomodulating and anti-infection regimens, often involves the need to navigate medication access issues. Transplant patients are impacted by insurance coverage barriers, drug shortages, infusion access barriers, and off label drug use.⁷ Additionally, transplant pharmacists have advanced into various clinical settings including ambulatory care, quality assessment and performance improvement, pediatrics, and research, to name a few. As the field progresses into new venues, there is also a commensurate increase in the need for specialized SOT pharmacists and a benchmark for their knowledge and skills. As such, the SOT pharmacist community petitioned for Board of Pharmacy Specialties recognition of SOT as a specialty area of pharmacy practice with a corresponding board certification opportunity. ^{8, 9}

Fall of 2021 marks the first offering of the Board of Pharmacy Specialties Board Certified Transplant Pharmacist (BCTXP) examination. This certification designates expertise in the SOT pharmacotherapy field, ensuring ongoing improvement of patient outcomes.

Visit the SOT Pharmacy webpage for more information about the BCTXP certification, including eligibility requirements and examination content outline.

References

1. Mitchell JF. Pharmacist involvement as a member of a renal transplant team. Am J Hosp Pharm. 1976;33:55–8.
2. Burckart GJ. Transplant pharmacy: 30 years of improving patient care. Ann Pharmacother. 2007;41:1261–3.
3. OPTN Bylaws: Appendix D [Internet]. Richmond, VA: Organ Procurement and Transplantation Network (OPTN); 2020. Available from: https://optn.transplant.hrsa.gov/media/1201/optn_bylaws.pdf. Accessed August 24, 2021.
4. American Society of Health-System Pharmacists. Required Educational Outcomes, Goals, and Objectives for Postgraduate Year Two (PGY2) Pharmacy Residencies in Solid Organ Transplant. Available at: https://www.ashp.org/-/media/assets/professional-development/residencies/docs/pgy2-transplant-cago-2017.ashx. Accessed August 24, 2021.
5. Taber DJ, Pilch NA, Trofe-Clark J, Kaiser TE. A National Survey Assessing the Current Workforce of Transplant Pharmacists Across Accredited U.S. Solid Organ Transplant Programs. Am J Transplant. 2015;15:2683-90.
6. Maldonado AQ, Hall RC, Pilch NA, Ensor CR, Anders S, Gilarde JA, et al. ASHP Guidelines on Pharmacy Services in Solid Organ Transplantation. Am J Heal Syst Pharm. 2020;77:222–32.
7. Lushin E, McDermott J, Truax C, Lourenco L, Mariski M, Melaragno J, et al. A multicenter case series documenting Medicare Part D plan denials of immunosuppressant drug coverage for organ transplant recipients. Am J Transplant. 2021;21:889-96.
8. Anders S, Basalyga V, Campara M, Condon A, Pilch NA, Skelton JB, et al. A Petition to the Board of Pharmacy Specialties Requesting Recognition of Solid Organ Transplantation Pharmacy Practice as a Specialty. 2018.
9. Pilch N, Fleming J, Crowther B, Maldonado A, Taber D. It is time for board certification in transplant pharmacotherapy. Am J Transplant. 2018;18:2370-1.