Progress in Transplantation最新文献

{"title":"Pancreatic Exocrine Secretion and Weight Gain After Pancreas Transplantation.","authors":"Amanda Van Jacobs,&nbsp;Michael D Williams,&nbsp;Oliver G Ralph,&nbsp;Adan Z Becerra,&nbsp;Edie Y Chan,&nbsp;Oyedolamu Olaitan","doi":"10.1177/15269248231189877","DOIUrl":"10.1177/15269248231189877","url":null,"abstract":"<p><strong>Introduction: </strong>Weight gain after pancreas transplant is a poorly understood phenomenon thought to be related to increased posttransplant insulin production, immunosuppressive medications, and appetite changes. No study has investigated the effect of increased exocrine secretion posttransplant.</p><p><strong>Aims and hypothesis: </strong>We hypothesized that exocrine function, measured by fecal elastase-1 (FE-1), was normal posttransplant and not correlated with weight gain. Our primary aim was to investigate changes in FE-1 levels with pancreas transplantation and to correlate this with weight gain. Establishing weight trends and identifying additional correlating factors were secondary aims.</p><p><strong>Design: </strong>Forty-two patients that underwent simultaneous pancreas and kidney or pancreas after kidney transplant at a single center between 2013 and 2021 were included. Fecal elastase was measured prospectively in each patient at a single time point, with >500 µg/g categorized as high. Weight and C-peptide values were obtained. All the patients were on steroid-free immunosuppression.</p><p><strong>Results: </strong>Nineteen patients (45%) had fecal elastase levels >500 µg/g, with a maximum of 3910 µg/g; 43% had levels greater than twice the upper limit of normal. The biggest increase in weight occurred between years 1 and 2, which continued to a median weight gain of 14% at 3 years. There was no correlation between weight gain and FE-1, pretransplant C-peptide levels, or duration of diabetes.</p><p><strong>Conclusion: </strong>This study demonstrated supranormal fecal elastase levels and weight gain posttransplant; however, there was no correlation. Future study with serial FE-1 before and after transplant is needed to better assess its correlation with weight gain.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"236-241"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10082429","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":"Developing a Healthy Lifestyle Program for Recent Kidney Transplant Recipients.","authors":"Cheryl A Gibson,&nbsp;Aditi Gupta,&nbsp;Abhijit Naik,&nbsp;Debra K Sullivan,&nbsp;Mona Doshi,&nbsp;Jim Backes,&nbsp;Susan Harvey,&nbsp;Jaehoon Lee,&nbsp;Rebecca Mount,&nbsp;Heather Valentine,&nbsp;Kelly Shaffer","doi":"10.1177/15269248231189878","DOIUrl":"10.1177/15269248231189878","url":null,"abstract":"<p><strong>Introduction: </strong>Many kidney transplant recipients experience weight gain in the first year after transplantation.</p><p><strong>Research question: </strong>The objective of this research study was to assess the desires of recent kidney transplant patients about the design features of a healthy lifestyle program to counter unnecessary weight gain.</p><p><strong>Design: </strong>In this descriptive study, recent recipients at 2 transplant centers were invited to participate in an online survey. Survey items included sociodemographic information, current medications, health conditions, weight change posttransplant, diet behaviors, physical activity participation, and desired features of a lifestyle program.</p><p><strong>Results: </strong>Fifty-three participants, mean age 60.5 (11.2) years, primarily males, completed surveys. Forty percent gained weight posttransplantation with many indicating struggling with their diet. Physical activity levels stayed the same (17%) or decreased (40%) posttransplantation. Eighty-seven percent of participants indicated they would participate in an online lifestyle program and 76% wanted online physical activity and nutrition sessions to meet at least once weekly. Suggestions about the type of information and activities, included eating strategies (eg, how to eat healthfully at restaurants, grocery shopping tips, and recipes), resources for at-home physical activities, access to cooking classes, and apps to track both activity and food intake.</p><p><strong>Conclusion: </strong>Recent kidney transplant recipients would benefit from and desired to join a lifestyle program featuring tailored nutrition education and physical activity coaching. Gathered information will be used to inform and tailor a lifestyle program. Identifying features for the prevention of unnecessary weight gain with patients' input is essential for promoting and sustaining healthy behaviors.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"193-200"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10069166","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 Description of Resource Utilization and Costs in Acute on Chronic Liver Failure.","authors":"Pei Xue,&nbsp;Erin Zisman,&nbsp;Preet Patel,&nbsp;Neha Jakhete,&nbsp;Sasan Sakiani,&nbsp;T Joseph Mattingly,&nbsp;Kirti Shetty","doi":"10.1177/15269248231189876","DOIUrl":"10.1177/15269248231189876","url":null,"abstract":"Liver transplantation offers a life-saving option for those with liver cirrhosis, but it is associated with signi fi cant healthcare costs with some","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 3","pages":"272-274"},"PeriodicalIF":0.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10134327","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":"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}