Progress in Transplantation最新文献

{"title":"Consent or Permission to Publish for Case Reports.","authors":"Rebecca P Winsett","doi":"10.1177/15269248231190185","DOIUrl":"10.1177/15269248231190185","url":null,"abstract":"","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"191-192"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10134328","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":"Engaging Adolescent Heart Transplant Recipients Through In-App Messaging During Mobile Health Intervention.","authors":"Michael O Killian,&nbsp;Lisa Schelbe,&nbsp;Mia Liza A Lustria,&nbsp;Madison Watkivs,&nbsp;Dipankar Gupta","doi":"10.1177/15269248231189862","DOIUrl":"10.1177/15269248231189862","url":null,"abstract":"<p><p><b>Introduction:</b> Adolescents heart transplant recipients experience difficulty with adherence to immunosuppressive medication leading to increased risk of organ rejection, hospitalization, and mortality. Few interventions have been successful to promote medication adherence in adolescent heart transplant patients as most fail to engage the patient in the behavioral change process and support patient-provider communication. The purpose of this study was to explore the nature and degree of in-app communication between adolescent heart transplant recipients and nursing staff during an asynchronous mobile video directly observed therapy intervention. <b>Methods:</b> A content analysis of 894 in-app messages exchanged between 10 adolescent patients and nurses during a 12-week mobile-based intervention was conducted. Two authors used an inductive, iterative process to guide a thematic analysis of the asynchronous in-app messages with high interrater reliability ranging from 81.5% to 100%. <b>Findings:</b> In-app messages fell under 3 broad content categories: (1) interpersonal support and rapport-building, (2) medically related questions and information, or (3) functional information about the intervention and the mHealth app. Results demonstrated the degree to which interpersonal engagement occurred during the intervention, the nature of these exchanges, and their relationship to medication adherence. <b>Conclusions:</b> The study provided insights into the feasibility and benefits of 2-way communication features of the directly observed therapy intervention in promoting engagement and in improving medication adherence among adolescent heart transplant patients. Continued research and clinical focus on patient engagement and impactful aspects of interpersonal communication could aid in the translation of this intervention into standard clinical care at pediatric transplant centers.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"229-235"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10080314","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":"Transplant Center Access to Dermatology.","authors":"Sara Yumeen,&nbsp;Benjamin J Kahn,&nbsp;Frank Deng,&nbsp;Travis W Blalock","doi":"10.1177/15269248231189874","DOIUrl":"10.1177/15269248231189874","url":null,"abstract":"","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"275-276"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10076208","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":"Attitudes to Organ Donor Registration in England Under Opt-Out Legislation.","authors":"Natalie L Clark,&nbsp;Lee Copping,&nbsp;Katherine Swainston,&nbsp;Grant J McGeechan","doi":"10.1177/15269248231189869","DOIUrl":"10.1177/15269248231189869","url":null,"abstract":"<p><p><b>Introduction:</b> In England, everyone is considered an organ donor unless they have registered for opt-out donation. <b>Research Question:</b> This study evaluated positive statements and negative affective attitudes against anticipated organ donor status and whether the order in the attitudes and statements presented impacted organ donor intention under an opt-out system. <b>Design:</b> A quasi-experimental mixed between-within design was employed with participants assigned to 1 of 2 conditions. Participants in the first condition received negative affective attitude statements followed by positive statements. This was reversed in the second condition to combat ordering effects. Participants (<i>N</i> = 679) were asked about their donor status under an opt-out system. There were three groups: opt-in (actively), opt-out/not sure, and deemed consent (no objection). Organ donor intentions were measured at three intervals: baseline, post-positive statements, and post-negative attitudes. <b>Results:</b> Approximately 10% of participants would opt-out or were unsure of their intentions to be an organ donor under an opt-out system. Significant effects were found in both positive statements and negative affective attitudes. All groups expressed greater medical mistrust and were most influenced by cognitive attitudes. <b>Conclusions:</b> Under the opt-out system in England, it is anticipated that the majority would actively opt-in or have no objection to being automatically registered as an organ donor. Public health campaigns would benefit from promoting the most influential positive statements and refuting the most detrimental negative attitudes to increase intentions of those who plan to opt-out or are unsure.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"208-215"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10081924","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":"Critical Care Length of Stay and Support Requirements for Patients Postpancreas Transplant.","authors":"Dominic Wu,&nbsp;James Hanison","doi":"10.1177/15269248231189875","DOIUrl":"10.1177/15269248231189875","url":null,"abstract":"<p><p><b>Introduction:</b> Pancreas transplant is one of the UK's less commonly done solid abdominal organ transplants. The transplant is reputed for its high-risk postsurgical complications due to multiple patients, procedures, and immunological factors. For this reason, patients are habitually admitted to the intensive care unit for postlaparotomy care, physiological support, and graft function monitoring during their immediate postoperative course. <b>Project Aim:</b> This program evaluation analyzed the trend in critical care length of stay and organ support requirements for patients following whole pancreas transplantation. The aim was to use these baseline data as performance metrics to enable a safer transition and Plan-Do-Study-Act (PDSA) cycles in improving the delivery of enhanced recovery service. <b>Design:</b> A retrospective chart review was performed using records from Phillips IntelliSpace Critical Care and Anaesthesia system to evaluate the institutional outcomes of patients < 18 years admitted to intensive care following pancreas transplantation between January 1, 2018, and December 31, 2021. Islet-cell transplant recipients were excluded as there is a different postoperative recovery. <b>Results:</b> The data suggested that although patients require a higher level of observations, blood pressure management, blood gas, and glucose monitoring during their first week of transplant, these patients did not routinely require the full range of critical care support. <b>Conclusion:</b> The present evaluation reported the organ support requirements for these transplant recipients. The results will generate further interest in enhanced recovery and service evaluation projects to streamline the postoperative care of these patients from the operating theatre back to the transplant wards.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"256-260"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10082430","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":"Successful Re-transplantation of Kidney in a Child with Heterozygous Prothrombin G20210A Mutation.","authors":"Ratna Acharya,&nbsp;Rachel Bush,&nbsp;Felicia Johns,&nbsp;Kiran Upadhyay","doi":"10.1177/15269248231189873","DOIUrl":"10.1177/15269248231189873","url":null,"abstract":"Prothrombin (PT) G20210Amutation is one risk factor for early renal allograft loss in pediatric kidney transplantation. There is no consensus whether screening for this mutation is necessary in all children undergoing transplantation. In asymptomatic children with this mutation, it is not clear whether prophylactic perioperative anticoagulation is beneficial. We describe a child with heterozygous PT G2021A mutation who underwent a successful re-transplantation following an early first kidney allograft loss. Parents of the patient provided consent for publication of this case report.","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"268-269"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161392","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 Evolution of Communication and Education Strategies of Canadian Transplant Programs During the Pandemic.","authors":"Shaifali Sandal,&nbsp;Elie Fadel,&nbsp;Emilie Trinh,&nbsp;Michael Gagnon,&nbsp;Andrea Herrera-Gayol,&nbsp;Marcelo Cantarovich","doi":"10.1177/15269248231189865","DOIUrl":"10.1177/15269248231189865","url":null,"abstract":"breakdowns","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"277-279"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10081916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Single-Center Retrospective Evaluation of Decision-Making and Factors Motivating Hand Transplant Candidates.","authors":"Kasey R Boehmer, Cassie C Kennedy, Ian G Hargraves, Joan M Griffin, Andrea E Garcia-Bautista, Brianna B Sanchez, Avudaiappan Chokkalingam, Dawn M Finnie, Adam R Miller, Steven L Moran, Fantley C Smither, Hatem Amer, Sheila Jowsey-Gregoire","doi":"10.1177/15269248231189863","DOIUrl":"10.1177/15269248231189863","url":null,"abstract":"<p><strong>Introduction: </strong>Advancements in vascularized composite allotransplantation have made hand transplants possible for persons living with upper limb loss. Hand transplantation is not a life-saving procedure, but rather a quality-of-life enhancing procedure; hence the risk of morbidity and mortality must be weighed against improvements in function and appearance. This study explored the decision-making process of patients evaluated for hand transplantation.</p><p><strong>Methods/approach: </strong>A qualitative case series study using retrospective chart data of evaluations was conducted between January 1, 2011 and February 28, 2020. Notes were extracted and read by three reviewers. Each case was summarized noting similarities and differences.</p><p><strong>Findings: </strong>Nine patients underwent evaluation. Eight were no longer under evaluation and did not receive transplant; one was still undergoing evaluation. Patient motivations for evaluation were dissatisfaction with prostheses or self-image, chronic pain, performing activities of daily living, occupation, burden placed on caregivers, and concerns about overuse of non-affected limbs. Patients chose not to pursue transplantation due to rehabilitation time, immunosuppression, alternative treatments, and social and financial challenges. The clinical team discontinued evaluations due to unmet evaluation requirements, medical contraindications, or treatment alternatives. Different modes of shared decision-making were present depending on the party most heavily featured in the charts as driving decisions.</p><p><strong>Discussion: </strong>This was an examination of shared decision-making with hand transplant candidates who did not proceed to transplant. Reasons for choosing alternative strategies for management were multifactorial. Lessons learned regarding patient motivations and shared decision-making can inform future interventions to better support patients.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"216-222"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11146747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10076757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kounis Syndrome, an Unrecognized Presentation of Perioperative Anaphylaxis in a Transplant Candidate.","authors":"Andrew D Hong,&nbsp;Zachary J Fleissner,&nbsp;Cesar Campos-Cuellar,&nbsp;Alexei Gonzalez-Estrada,&nbsp;Shennen A Mao,&nbsp;R Doris Wang,&nbsp;Sher-Lu Pai","doi":"10.1177/15269248231191485","DOIUrl":"10.1177/15269248231191485","url":null,"abstract":"A 52-year-old male presented for kidney transplantation with pretransplant echocardiography showing normal left ventricular chamber size and systolic function. After the induction of general anesthesia, a latex urinary catheter was placed. Within 12 min, the patient presented with diaphoresis, diarrhea, mean arterial pressure of 30–40 mmHg, and electrocardiogram (ECG) ST-elevations. Echocardiography showed global akinesis with diminished biventricular contractility and dilated four chambers. He had no response to IV phenylephrine and vasopressin boluses. Presumed an ST-elevation myocardial infarction occurred as the mean arterial pressure further dropped to 20 mmHg, the decision to use the extracorporeal membrane oxygenation (ECMO) machine before proceeding to percutaneous coronary intervention (PCI) was made. Epinephrine (20 mcg) was given in an attempt to avoid complete cardiopulmonary collapse. Echocardiography then showed a return of function in the right ventricle and inferior wall, while the septum and the anterior wall continued to be hypokinetic. This prompted the start of the epinephrine infusion (0.1 mcg/kg/min). The mean arterial pressure improved to mid-60s mmHg, ECG ST-elevation resolved, and echocardiography showed global improvement in contractility. Now suspecting Kounis syndrome, the transplant surgery, ECMO placement, and PCI procedure were canceled. Acute serum tryptase (serum tryptase sample taken within 2 hours after onset of anaphylaxis) and serial serum troponin levels were obtained.","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"270-271"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10076760","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":"Outcomes and Resource Utilization in Liver Transplant Recipients Who Underwent Expedited Transplant Evaluation.","authors":"Emily Lin,&nbsp;Anish Patel,&nbsp;Ericka Young,&nbsp;Yinglin Gao,&nbsp;Jiahao Peng,&nbsp;Jakub Woloszyn,&nbsp;Michael L Volk,&nbsp;Mina O Rakoski","doi":"10.1177/15269248231189870","DOIUrl":"10.1177/15269248231189870","url":null,"abstract":"<p><strong>Background: </strong>Expedited liver transplant evaluations of critically ill patients can be challenging due to limited time for data gathering and psychosocial evaluation.</p><p><strong>Aims: </strong>To compare clinical outcomes between expedited and traditional transplant evaluation patients and assess for differences in outpatient resource utilization and staff burden between groups.</p><p><strong>Design: </strong>Adult liver transplant recipients who underwent transplant from 2015 to 2019 were included. Expedited evaluation was defined as time from initiating transplant evaluation to transplant listing <2 weeks. Primary outcomes included rates of graft rejection, graft failure, and death within 1-year posttransplant. Secondary outcomes included number of acute care visits, office visits, and medical record documentation made by transplant staff within 1-year posttransplant. Outcomes were compared using Cox regression models.</p><p><strong>Results: </strong>Of the 335 patients included, 92 (27.5%) were expedited and 243 (72.5%) were traditional. Expedited patients were significantly younger, had greater MELD scores, and required more inpatient care and life support at time of transplant. There was no significant difference in risk of graft rejection (HR 1.3, <i>P</i> = .4), graft failure (HR 1.3, <i>P</i> = .6), or mortality (HR 1.0, <i>P</i> = .9) between groups. Expedited transplant was not associated with increased healthcare or staff utilization: acute care visits (rate ratio 0.9, <i>P</i> = .7), office visits (β = -1.05, <i>P</i> = .2), and medical record documentation (β = 3.4, <i>P</i> = 0.4).</p><p><strong>Conclusions: </strong>Despite being more critically ill, patients requiring expedited transplant evaluation have favorable outcomes after transplant and do not require more intensive staff time and resources compared to traditional candidates.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"223-228"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10433869","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}