腎臟移植手術的成功並不代表病人終生的生活品質就此改善，除了病人須遵守移植術後醫療人員叮嚀，例行接受各項檢查、適當的飲食及適度的運動等衛生教育外，免疫抑制劑及其因共病而併服多重藥物使用之正確與否，是決定移植病人移植體存活與生活品質優劣的重要因素。如同慢性病人一樣，他們需定期於門診追蹤，必要時將依需求調整用藥，故而病人對醫師調整藥物之目的若不甚清楚，很容易因疏忽而錯服藥物，甚至威脅移植器官的存活，移植門診藥事照護即因應這類病人之需求而設置。
奇美醫學中心於2005 年成立腎臟移植藥事照護門診，由藥師與醫師、營養師在移植門診時段共同照護病人。本文目的在於回顧、說明本院移植藥事照護門診之設置與照護進行之方式，並分享過去十年臨床藥師在此領域中對醫師處方之建議，如藥物的選擇(34.5%)、劑量的調整(14.5%)、藥物動力相關檢驗值之判讀(12.7%)，以及對病人用藥認知之改變（認知提升13.78 %, p < 0.001），並提出未來藥師在此團隊中應扮演更積極角色之展望，以供國內有意執行藥事照護門診之移植中心參考。
 

A success of renal transplantation is not necessarily related to their lifelong improvement of quality of life. Addition to the transplant recipients have to take the advice for post-transplant care, checkups of physical examination, choice of suitable food and exercises, the correct use of immunosuppressive agents and multiplemedications due to comorbidity play an important role for the graft survival and quality of life. Just as the chronically ill patients, transplant recipients should routinely schedule for monitoring and might be adjusted for medication regimen according to the presenting conditions. If the patients are unaware why the physicians change their regimens, things like unintentional uses of medicines might easily happen. This might tragically lead to negative impacts to graft survival. Accordingly, the renal transplant pharmaceutical care clinic was established.
Since 2005, we have offered pharmaceutical care in renal transplantation clinic at Chi-Mei Medical Center; both clinical pharmacists and nutritionists have been disposed to support physicians to provide professional care for transplant recipients in the clinics. In this article, we aimed to make a description of the setting of pharmaceutical care in the renal transplant clinic and the procedure of patient care provided by clinical pharmacists, which included recommendations making in this field; medication selections (34.5%), dosage adjustment (14.5%), interpretation of clinical pharmakinetics relative data (12.7%), and significantly improvement of patients’ cognition (13.78%, p < 0.001) over the years. In addition, we offered the recommendations for a clinical pharmacist to be in the multidisciplinary team, and for a reference to some other transplantation centers that tent to develop pharmaceutical care.