Progress in Transplantation最新文献

{"title":"Understanding Care Partner Experiences in the First Month After Durable Left Ventricular Assist Device Implantation.","authors":"Bernice Coleman, Bibiana Martinez, Lianna Z Ansryan, Ariz Amoroso Guzman, Harriet Aronow, Linda Olanisa, Michelle Williams-Rivers, David Chang, Carmelita Runyan, Newman Huie, Jennifer Pamu, Kristin E Sandau","doi":"10.1177/15269248251343383","DOIUrl":"https://doi.org/10.1177/15269248251343383","url":null,"abstract":"<p><strong>Introduction: </strong>Durable left ventricular assist devices serve as a critical bridge to heart transplantation for patients with advanced heart failure. Yet the demands placed on care partners (CPs) are often underestimated, and their well-being in supporting postimplant recovery is frequently overlooked.</p><p><strong>Methods/approach: </strong>This qualitative single-site study explored the struggles and support needs of 13 CPs who participated in audio-recorded interviews following device placement.</p><p><strong>Findings: </strong>Data analysis, using inductive content analysis, revealed 6 major themes: feeling unprepared, being hypervigilant, feeling overwhelmed, the vanishing CP, lacking self-care, and needing connection with other CPs. Findings revealed that CPs often felt overlooked by healthcare teams, contributing to emotional distress and isolation, while inadequate education on perioperative complications and minimal peer support reinforced their sense of being unprepared.</p><p><strong>Conclusion: </strong>These results underscored the integral role that CP well-being played in sustaining successful device management and ensuring patients remained eligible for heart transplantation. Psychosocial services, peer support, and structured educational programs may help mitigate the strain experienced by CPs and improve transplantation outcomes. Embedding CP needs into the transplant pathway, beginning at implantation, was essential to preventing burnout, maintaining candidacy, and improving overall posttransplant success. Refinements in CP-centered interventions may help reduce hospital readmissions, enhance device adherence, and support emotional resilience. By prioritizing CP support within advanced heart failure management, transplant programs can optimize both patient and CP well-being and foster positive outcomes. Such focus ensures bridging to transplantation and hope for families.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"15269248251343383"},"PeriodicalIF":0.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participant Experiences With a Virtual Peer Coaching and Grief Support Intervention for Organ and Tissue Donor Families.","authors":"Samantha B Klitenic, Jasmine M Akhtar, Carolyn N Sidoti, Tara Storch, Elizabeth Hughes, Hannah Showalter, Paige Anderson, Tara Kane, Tessa Flower, Stephen P Wall, Allan B Massie, Brittany Koons, Macey L Levan","doi":"10.1177/15269248251343382","DOIUrl":"https://doi.org/10.1177/15269248251343382","url":null,"abstract":"<p><strong>Introduction: </strong>Research shows that donor families report feeling abandoned, lacking social support, and receiving insufficient aftercare services. To meet the needs of these families, Taylor's Gift Foundation developed a free, virtual grief support program that pairs participating donor family members with Caring Guides trained in assertive community engagement and offers peer-facilitated support groups. <b>Project Aim:</b> The aim was to assess participant experiences with Taylor's Gift Foundation grief support program to understand its impact on grief symptoms, donor family access to grief support, and perceived social support. <b>Design:</b> Researchers conducted a qualitative evaluation using semi-structured interviews with 21 program participants. Results were analyzed using rapid qualitative analysis and descriptive statistics. <b>Results:</b> Eighteen (86%) participants worked with Caring Guides, 12 (57%) attended an average of 7 support groups, and 8 (39%) worked with Caring Guides and attended support groups. Eleven (52%) program participants reported difficulties accessing mental health services. Most program participants (86%) reported a decrease in grief intensity since enrolling in the program. <b>Conclusion:</b> Effective aftercare services were critical in helping donor families cope with, and adapt to, their loss. The Taylor's Gift Foundation grief support program helped donor family members access otherwise inaccessible grief support services and provided a valuable means of social support.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"15269248251343382"},"PeriodicalIF":0.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Influence on Organ Donation by Actor Portrayal of Altruism on the Television Show <i>Grey's Anatomy</i>.","authors":"Brian L Quick, Lauren A Kriss","doi":"10.1177/15269248251343380","DOIUrl":"https://doi.org/10.1177/15269248251343380","url":null,"abstract":"<p><p>IntroductionEntertainment portrayals of organ donation continue to inform viewers' beliefs. Research showed many of the belief's individuals have about organ donation rose from exposure to popular entertainment programs such as Grey's Anatomy. Grey's Anatomy routinely portrays medical doctors in a realistic way as altruistic and heroic medical care providers.Research QuestionThe central question asked was whether favorable portrayals resulted in audience's perceiving real world doctors as altruistic and in turn, favorable organ donation registration attitudes.DesignThe current study employed a cross-sectional survey to adults.ResultsThe current study found a positive association between show exposure and show realism among adults (<i>N</i> = 211). Moreover, show realism was positively associated with a belief in doctor altruism. In turn, altruism was positively associated with favorable perceptions toward registering as an organ donor.ConclusionThe results showed that realism influenced beliefs about medical provider altruism, which in turn can affect attitudes toward organ donation. The next step in this research is to employ rigorous experimental designs to identify the specific contexts and narratives in which these medical portrayals have the greatest impact.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"15269248251343380"},"PeriodicalIF":0.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dialysis Social Workers' Perspectives on Barriers and Facilitators to Kidney Transplantation.","authors":"Gloria Chen, Liana Petruzzi, Amanda Ryan, Chandi Mulchand, Lisa M Blackwell, Nicole A Turgeon, Joel T Adler","doi":"10.1177/15269248251343378","DOIUrl":"https://doi.org/10.1177/15269248251343378","url":null,"abstract":"<p><strong>Introduction: </strong>Dialysis social workers are integral in the transplant evaluation process; however, research on dialysis social workers' perspectives on access to kidney transplantation is limited. <b>Methods:</b> A mixed methods study examining dialysis social workers' perspectives on transplant barriers and facilitators. Dialysis social workers completed online surveys and participated in virtual, semi-structured interviews. Qualitative data were recorded, transcribed, and analyzed using thematic analysis. Quantitative data were analyzed descriptively. <b>Results:</b> Twenty-seven dialysis social workers completed surveys, and 15 participated in qualitative interviews. Participants were predominantly female (93%) and White (89%). While the majority (67%) had practiced as a social worker for 6+ years, most had ≤5 years of dialysis experience (52%). The majority described the transplant referral process as somewhat easy (67%) and rated their relationship with transplant programs as either fair or good (78%). Both survey and interview data identified similar patient-level barriers, such as lack of social support and obesity. Interviews further elucidated organizational and system level barriers including tensions between dialysis and transplant centers, transplant center accessibility, and systemic discrimination. Identified facilitators included patient motivation, transplant center communication, and transplant resources. <b>Conclusion:</b> Dialysis social workers provided a unique perspective on barriers and facilitators to kidney transplantation. While barriers to transplant were often considered at the patient level, organizational and system level factors were crucial to understanding transplant access. These findings could inform future efforts between dialysis and transplant centers to improve access to kidney transplantation.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"15269248251343378"},"PeriodicalIF":0.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrative Review of Frailty, Patient Mortality and Graft Failure in Solid Organ Transplant.","authors":"Theresa M Miller, Cynthia L Russell","doi":"10.1177/15269248251343387","DOIUrl":"https://doi.org/10.1177/15269248251343387","url":null,"abstract":"<p><p>IntroductionCharacteristics and the impact of frailty on adult solid organ transplant recipients have not been clearly described. The purpose of this integrative review was to identify characteristics of frailty and associations between frailty and patient mortality and graft failure in adult solid organ transplant recipients.MethodsAn integrative literature review was performed using Cooper's integrative methodology. PubMed, Excerpta Medica, and the Cumulative Index of Nursing and Allied Health Literature databases were searched using the terms frailty and transplant. Inclusion criteria were primary research reports, written in English, focusing on adult solid organ transplant recipients, and including graft or patient survival outcomes.ResultsThe review included 35 articles, were largely retrospective, and published between 2015 and 2023 in 11 different countries. Most studies were single-center studies that were not theory-based, and liver transplant recipients were highly represented. Males outnumbered females in the majority of studies and White race was represented in half of the studies. Most studies used one strategy to measure frailty, and modified versions of the Physical Frailty Phenotype were the measurement used most often. Of the 35 articles that investigated the association of frailty with patient mortality, 44 measures were used, and of those, 32 showed a significant association. For graft failure, of the 10 studies included, half showed a significant association between frailty and graft failure.ConclusionThis integrative review offers insights into the characteristics and the association between frailty, patient mortality, and graft failure.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"15269248251343387"},"PeriodicalIF":0.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Antimetabolite Intolerance in Older Lung Transplant Recipients.","authors":"Hansa Mreyoud, Linda Fitzgerald, Jeong M Park, Elizabeth Wilpula, Elizabeth Belloli, Krysta Walter","doi":"10.1177/15269248251327419","DOIUrl":"https://doi.org/10.1177/15269248251327419","url":null,"abstract":"<p><p><b>Introduction:</b> Adverse effects from antimetabolites often lead to therapy adjustments; older patients may be more susceptible to these effects. <b>Project Aims:</b> Compare the intolerance of antimetabolites between older and younger lung transplant recipients. <b>Design:</b> A single-center, retrospective analysis of adult lung transplant recipients transplanted between January 1, 2019 and October 31, 2021 was conducted. Patients were stratified by age at the time of transplant (≥60 or <60 years) and assessed for the first year posttransplant. The primary outcome was the incidence of antimetabolite intolerance (defined as dose adjustment, agent/formulation change, or holding/discontinuation of agent). Secondary outcomes included reason for intolerance, safety (infection and leukopenia), and efficacy (rejection and patient/graft survival). <b>Results:</b> One hundred and nine recipients were included; 54 in the older (≥60 years) and 55 in the younger (<60 years) cohort. Most were initiated on azathioprine (74%) posttransplant. Antimetabolite intolerance occurred in 61% of older and 53% of younger recipients (<i>P</i> = 0.377). The most common reasons for intolerance were leukopenia followed by gastrointestinal side effects. Biopsy-proven acute rejection occurred more often in the older cohort (39% vs 18%, <i>P</i> = 0.017); this no longer remained significant when controlling for induction, indication, transplant type, gender, and antimetabolite intolerance (OR 0.36, 95% CI 0.11 to 1.15). There was no difference in the incidence of leukopenia, bacterial infection, or graft/patient survival within 1 year posttransplant. <b>Conclusion:</b> Antimetabolite intolerance between older and younger lung transplant recipients was similar. Most required modification to the initial antimetabolite regimen due to leukopenia and gastrointestinal side effects.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"15269248251327419"},"PeriodicalIF":0.6,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of the Earthquake in Türkiye on Organ Donation and Transplantation.","authors":"Buket Celik, Yaprak Sarigol Ordin, Eda Ayten Kankaya","doi":"10.1177/15269248251327422","DOIUrl":"https://doi.org/10.1177/15269248251327422","url":null,"abstract":"<p><p><b>Introduction:</b> Organ shortage is a global issue. A disaster like an earthquake not only increases the number of people in need of organs but also negatively affects the treatment processes of patients who have already undergone transplants. <b>Aim:</b> The aim of this study is to examine the impact of the earthquake that occurred on February 6, 2023, in Türkiye on organ donation and transplantation. <b>Methods:</b> The study was conducted using open-access statistical data of 2022-2023 years available on the official website of the Tissue, Organ Transplantation, and Dialysis Services of the Ministry of Health in Türkiye. <b>Results:</b> It was found that the earthquake did not affect the number of organ transplants, organ donations, brain death diagnoses, and family consent in Türkiye, but in the provinces affected by the earthquake, it decreased the number of organ donations, brain death diagnoses, and living donors and increased the number of family consent. <b>Conclusion:</b> Healthcare professionals in disaster-affected regions should receive specialized training to maintain critical organ donation protocols, supported by decentralized coordination systems that ensure the continuity of these processes even when central networks are disrupted.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"15269248251327422"},"PeriodicalIF":0.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Three Decade Analysis of Trends in Length of Stay After Liver Transplantation.","authors":"Spoorthi Kamepalli, Cameron Goff, Liam Ferreira, Ashley Montgomery, Anna Lang, George Cholankeril, Abbas Rana","doi":"10.1177/15269248251327428","DOIUrl":"https://doi.org/10.1177/15269248251327428","url":null,"abstract":"<p><p>IntroductionWhile survival following liver transplantation has improved over the past 3 decades, few studies have examined the changes over time in hospital length of stay (LOS), a surrogate for healthcare expenditure and an important short-term outcome measure.Research questionThe purpose of this study was to compare post-transplantation LOS over the last 3 decades.DesignA cross-sectional analysis of 150 603 adult liver transplant recipients between September 1987 and July 2021 from the UNOS database was conducted. The patients were placed into 3 eras (1987-1989, 1990-1999, and 2000-2021) based on a Join point regression analysis of significant time points of change in LOS trends. Risk factors that were significant in univariate analysis (<i>P</i> < .05) were included in the multivariable Cox regression analysis, which controlled for 29 donor/recipient characteristics.ResultsAmong adult patients, the average LOS following liver transplantation changed from 51.5 days in 1987 to 16.3 days in 2021, with a relatively steeper decline prior to 2000. On multivariable Cox regression, patients in both the 1987-1989 cohort (hazard ratio [HR]: 0.54, 95% confidence interval [CI]: 0.52-0.57) and the 1990-1999 cohort (HR: 0.77, CI: 0.76-0.78) had significantly prolonged lengths of stay (HR < 1 associated with later hospital discharge) compared to the 2000-2021 cohort.ConclusionsThis analysis found that mean LOS decreased over time in adult liver transplant recipients, even after controlling for donor and recipient-level factors. Future studies are needed to elucidate root cause factors for this decline in LOS over time.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"15269248251327428"},"PeriodicalIF":0.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Patient Voices to Conduct Patient-Centered Research.","authors":"Nicholas R Henry","doi":"10.1177/15269248241305024","DOIUrl":"10.1177/15269248241305024","url":null,"abstract":"","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"3-4"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Anxiety Measurement Scales in Pediatric Organ Transplantation Patients.","authors":"Zhe Yang, Michael O Killian","doi":"10.1177/15269248241305018","DOIUrl":"10.1177/15269248241305018","url":null,"abstract":"<p><strong>Introduction: </strong>Anxiety symptoms influence health outcomes in pediatric organ transplant recipients. Assessing the quality of anxiety scales is critical to address the psychological challenges these patients face. Variability in how anxiety is conceptualized across scales highlights the need for selecting appropriate instruments.</p><p><strong>Objective: </strong>This systematic review aimed to search and synthesize anxiety scales used in pediatric organ transplant studies, evaluate their reliability and validity, examine factors and group differences related to anxiety, and identify promising scales for this population.</p><p><strong>Methods: </strong>A systematic search was conducted using the terms \"(Anxiety) AND (organ transplant) AND (child* OR youth OR pediatric* OR adolescen*).\" Ten electronic databases were accessed.</p><p><strong>Results: </strong>Eighteen anxiety scales from 30 articles were identified. Fourteen scales measured specific anxiety types. Most scales demonstrated good to excellent reliability and validity. Associations between anxiety and demographics, psychological well-being, factors related to illness and treatment were observed. Five types of anxiety-related differences among groups and 6 promising anxiety scales for the target population were identified.</p><p><strong>Discussion: </strong>General and specialized anxiety scales were identified. Incomplete reporting of psychometric evidence restricted the quality assessment. Limitations include cultural and publication biases. Future research should focus on transplant-specific scales with psychometric validation across culturally diverse settings to ensure their quality and applicability.</p><p><strong>Conclusion: </strong>This review identified well-validated scales, such as State-Trait Anxiety Inventory for Children and Generalized Anxiety Disorder-7, effective for quick screening. Specialized instruments were used for nuanced anxiety concepts such as needle-related anxiety, illness-specific anxiety, and anxiety during the transition to adult care, but further psychometric validation is needed.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"22-40"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}