Renal transplantation in a noncompliant patient

To the Editor: The Image in Clinical Medicine entitled “Metastatic Calcification of the Shoulder in Chronic Renal Failure” (Sept. 2 issue)¹ leaves readers with the impression that a noncompliant patient who “began to take his phosphate-binding medications irregularly” was an acceptable candidate for transplantation and was therefore “referred for renal transplantation.” Nothing could be further from the truth. One of the chief relative and absolute contraindications to all types of solid-organ transplantation is demonstrated noncompliance. In an era of shrinking resources and with the shortage of available donor organs, transplantation centers have adopted policies that prevent valuable donor organs from.