Background: The United Network for Organ Sharing and Centers for Medicare and Medicaid Services require pharmacist participation on multidisciplinary transplant teams post transplantation while inpatient, but there are no guidelines on outpatient involvement once discharged.  Pharmacist involvement is integral in many aspects of outpatient transplantation care including medication accuracy, monitoring, and vaccination administration.
Objective: Evaluate the impact of transplant pharmacists on the care of pediatric kidney transplant recipients in the outpatient clinic.  
Methods: Retrospective chart review from 1/1/2022 to 6/30/2022 of all pediatric kidney transplant patients that were seen in the pediatric kidney transplant clinic to determine the impact of the transplant pharmacist in the outpatient setting. Charts were reviewed for pharmacist initiation of 1) medication doing changes, 2) new medications recommendations, 3) medication refills, 4) lab monitoring recommendations and/or 5) vaccine administration.
Results: A total of 126 patient encounters were reviewed. The transplant pharmacist was involved in 67 (53%) of the patient encounters. In 100% of visits, the pharmacist was able to perform medication reconciliation, adherence monitoring, and medication monitoring recommendations. The pharmacist was able to review the patient's pill box and find errors in patient medication administration and fix the error and provide education. The pharmacist recommended dosing changes in 30% of visits, vaccines in 31.3%, new medications in 16.4%, and refills in 30% of visits.  
Conclusions: Transplant pharmacists play an integral role in pediatric kidney transplant multidisciplinary teams. Through pharmacist intervention, we have been able to improve our vaccine rates and improve medication monitoring and dosing accuracy. Future studies will be needed to asses the cost benefit of these interventions.