Progress in Transplantation (Aliso Viejo, Calif.)最新文献

{"title":"Proposed Mechanism of Adherence in Caregivers Providing Care to Adults Living with a Left Ventricular Assist Device.","authors":"Lufei Young,&nbsp;Rita F D'Aoust,&nbsp;Chakra Budhathoki,&nbsp;Jesus M Casida","doi":"10.1177/15269248221107045","DOIUrl":"https://doi.org/10.1177/15269248221107045","url":null,"abstract":"<p><p><b>Introduction:</b> The left ventricular assist device (VAD) is commonly used as the bridge-to-transplantation therapy for heart failure patients who are on waitlist of heart transplant. The caregivers' adherence to the homecare regimen plays a vital role in patient outcomes. There is little evidence about the factors related to the caregiver adherence. The purpose of this study was to determine the factors influencing adherence in caring for patients living with a left ventricular device. <b>Methods:</b> The data were collected from 4 online caregiver support groups. Multiple linear regression models were used to determine associations between key variables. The structure equation modeling was used to identify the mediators of caregiver adherence. <b>Results:</b> A total of 96 participants' data entered the final analysis. The average age of the participants was 49.8 (SD = 12.88) years, majority were white (84%), female (80%), and married (81%). Caregiver self-efficacy was positively related to their adherence (r = 0.460, P < 0.001). Caregiver knowledge did not mediate the effect of training on self-efficacy. Caregiver self-efficacy did not mediate the effect of knowledge on adherence. There was no interaction between practice hours and knowledge on adherence. <b>Discussion:</b> The findings suggest significant association between caregiver self-efficacy and adherence to left ventricular assist home-care regimens. Additional research is needed to identify factors influencing caregiver adherence, leading to the development of evidence-based practice guidelines and to improve the outcomes in advanced heart failure patients living with left VAD.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"219-225"},"PeriodicalIF":0.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40104344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Short Primer on Developing a Manuscript for Publication.","authors":"Rebecca P Winsett","doi":"10.1177/15269248221114702","DOIUrl":"https://doi.org/10.1177/15269248221114702","url":null,"abstract":"","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"199-202"},"PeriodicalIF":0.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40604368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mixed Methods Assessment of Home-Based Video Pretransplant Lung Education","authors":"H. Mansell, M. Fenton, Julian S. Tam, Nicola Rosaasen, Louise Cardinal, Nicole Nelson","doi":"10.1177/15269248221107048","DOIUrl":"https://doi.org/10.1177/15269248221107048","url":null,"abstract":"Introduction: Patients awaiting lung transplantation must learn new information to successfully navigate the transplant process. A supplemental video series was piloted to patients at home during the Covid-19 pandemic to improve pre-transplant education. Methods: A mixed methods study was undertaken to assess patient experiences with this method of education, confirm the ideal timing of the education, and identify gaps that require further attention. Semi-structured interviews were conducted with 17 one-on-one or dyadic (patients and caregivers) who viewed the video series at home. A third-party researcher (not involved in creation of the educational materials) conducted the interviews by phone, which were audio recorded and then transcribed verbatim. NVivo 12 Pro for Windows software was used to code the data and identify emerging themes. Results: Participants indicated that home-based videos were applicable, and informative and helpful (4.7 on 5-point Likert scale) and appreciated the advice and experiences of real patients. They were satisfied with their transplant education (4.2/5). While there were few aspects that the participants disliked about the videos, the interviews elicited outstanding questions about the transplant process (eg, logistical aspects of travel) and transplant concerns (eg, medications, expenses, and precautions in daily life). Conclusion: Patients being assessed or listed for lung transplant valued the novel electronic video education, and we will implement the home-based process into standard of care after the patient's initial visit with the transplant respirologist. Pre-transplant education will be tailored to help address the outstanding gaps identified in this program evaluation.","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133626422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Secondary Analysis from The International BRIGHT Study For Gender Differences In Adherence To Nonpharmacological Health-Related Behaviors After Heart Transplantation.","authors":"Flavio Rose Epstein,&nbsp;Jacqueline Trammell,&nbsp;Chi-Mei Liu,&nbsp;Kris Denhaerynck,&nbsp;Fabienne Dobbels,&nbsp;Cynthia Russell,&nbsp;Sabina De Geest","doi":"10.1177/15269248221087435","DOIUrl":"https://doi.org/10.1177/15269248221087435","url":null,"abstract":"Heart transplant is an established treatment for selected patients with end-stage heart failure. Maximizing long-term survival is a primary focus of posttransplant management and research. Optimal outcomes after transplantation require adherence to a complex therapeutic regimen consisting of immunosuppressants, co-medications and nonpharmacological health-related behaviors, such as sun protection, sufficient physical activity, appropriate diet, smoking cessation, appropriate alcohol use and appointment adherence to follow-up visits. Adherence to nonpharmacological treatment can reduce the risk after transplant just as in the general population. Chronic exposure to immunosuppressant medications has potential serious side effects within 10 years of transplantation, including hypertension (70-90%), dyslipidemia (>50%), diabetes","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"138-147"},"PeriodicalIF":0.8,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40324936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Issues for Liver Transplantation in COVID-19 Recovered Recipients","authors":"K. Shetty, Z. Lominadze, K. Saharia, S. Challa, Maria Montenegro, R. Meier, Saad Malik, J. Alvarez-Casas, Sasan Sakiani, Neha R. Jakhete, N. Urrunaga, S. Gray, D. Maluf","doi":"10.1177/15269248221092742","DOIUrl":"https://doi.org/10.1177/15269248221092742","url":null,"abstract":"The ongoing burden of COVID-19 in persons with end stage liver failure necessitates the development of sound and rational policies for organ transplantation in this population. Following our initial experience with two COVID-19 recovered recipients who died shortly after transplant, we adjusted our center policies, re-evaluated outcomes, and retrospectively analyzed the clinical course of the subsequent seven COVID-19 recovered recipients. There were two early deaths and 5 successful outcomes. Both deceased patients shared common characteristics in that they had positive SARS-CoV2 PCR tests proximal to transplant (7-17 days), had acute on chronic liver failure, and suffered thromboembolic phenomena. After a careful review of clinical and virological outcome predictors, we instituted policy changes to avoid transplantation in these circumstances. We believe that our series offers useful insights into the unique challenges that confront transplant centers in the COVID-19 era and could guide future discussions regarding this important area.","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122626748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 6 C's of Normothermic Regional Perfusion","authors":"J. Richards, R. Gaurav, A. Butler, C. Watson","doi":"10.1177/15269248221087430","DOIUrl":"https://doi.org/10.1177/15269248221087430","url":null,"abstract":"deceased been utilised to the potential and up the ever-increasing for The main limitation of this approach is the extra warm ischemic injury, which is not experienced in donation after brainstem death (DBD), and which impacts on rates of early allograft dysfunction, primary non-function (PNF), ischemic cholangiopathy and failure.","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":"589 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122934629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providers and Families Weigh in on Delays to Pediatric Kidney Transplant Wait-List Activation.","authors":"Cristina M Farkas-Skiles,&nbsp;Ashley Feinsinger,&nbsp;Rachyl Pines,&nbsp;Amy D Waterman","doi":"10.1177/15269248211064875","DOIUrl":"https://doi.org/10.1177/15269248211064875","url":null,"abstract":"<p><strong>Introduction: </strong>Timely access to kidney transplant is essential to reducing mortality of children with kidney disease. We examined factors affecting providers' decisions to delay waitlisting, compared perceptions of important factors of providers to families, when delaying activation, and describe recommendations to improve support for pediatric patients and families to overcome waitlisting delays.</p><p><strong>Methods: </strong>Using a mixed-methods design, 20 providers and 20 families of pediatric patients with kidney disease, participated in interviews and surveys. Interviews were analyzed using thematic analysis. Surveys were analyzed with descriptive statistics.</p><p><strong>Results: </strong>Avoiding retransplantation, treatment nonadherence, poor psychological readiness for transplant, poor physical health, and greater need for social support were the key themes affecting providers' decisions to delay waitlisting. At least 70% of both providers and families felt that waitlisting should be delayed until patients and families had reliable access to transportation, mental health support, and caregivers who can better understand medical information. At least 70% of families surveyed felt it was important to delay waitlisting until they had regulated blood pressure and well-managed labs. Ethical concerns emerge that waitlisting practices may contribute to disparities in access to transplant.</p><p><strong>Conclusion: </strong>Providers and families agree that stabilizing the family situation and improving adherence to treatment are important reasons to delay waitlisting. However, pediatric patients facing greater disparities need easier access to psychological services, strengthened social support, access to economic resources, and stronger relationships with coordinators. Addressing patient burdens is essential for reaching more equitable listing practices.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"41-48"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39715565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methenamine for Recurrent Urinary Tract Infections in Solid Organ Transplantation.","authors":"Helen Sweiss,&nbsp;Suverta Bhayana,&nbsp;Reed Hall,&nbsp;Joelle Nelson,&nbsp;Elisabeth Kincaide","doi":"10.1177/15269248211064880","DOIUrl":"https://doi.org/10.1177/15269248211064880","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent urinary tract infections remain a challenge in solid organ transplant and have a negative impact on morbidity/mortality.</p><p><strong>Project aim: </strong>The purpose of this program evaluation was to determine the impact of methenamine on recurrent urinary tract infection in kidney and liver-kidney transplant recipients.</p><p><strong>Design: </strong>This retrospective review included patients > 18 years of age who received a kidney or liver-kidney transplant. Patients were divided into the following groups: (1) Methenamine therapy initiation received methenamine for ≥ 180 days or (2) Non-methenamine therapy: did not receive recurrent urinary tract infection prophylaxis. A total of 60 patients were included.</p><p><strong>Results: </strong>When comparing outcomes between methenamine therapy initiation and non-methenamine therapy group, a significant reduction in the rate of recurrent urinary tract infection was reported in the methenamine therapy initiation group (0.6 vs 1.3 per 180 patient days follow-up, P = 0.0005). A significant reduction was also noted with rate of asymptomatic bacteriuria, treatment failures, bacteremia, hospitalizations due to recurrent urinary tract infection, multi-drug resistant organism isolated, and the average duration of antibiotic use. A significant difference in the time to failure of methenamine therapy initiation versus non-methenamine therapy is noted up to 180 patient-days follow-up (RR 1.56, P = 0.0019).</p><p><strong>Conclusion: </strong>This evaluation supported methenamine therapy for recurrent urinary tract infection in kidney and liver-kidney transplant. The most significant impact of methenamine recurrent urinary tract infection was seen in the first 30 days after initiation.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"67-72"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39801184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Psychosocial Adjustment of Kidney Recipients in Canada's Kidney Paired Donation Program.","authors":"Sophia Bourkas,&nbsp;Marie Achille","doi":"10.1177/15269248211064881","DOIUrl":"https://doi.org/10.1177/15269248211064881","url":null,"abstract":"<p><p><b>Introduction:</b> Kidney paired donation programs have been implemented globally. The involvement of at least 2 donors in these programs might exacerbate recipients' debt of gratitude and guilt, worries about the donor's health, and worries about graft failure documented by previous studies. However, there is an absence of research on the psychosocial implications of kidney paired donation. This study aimed to provide an in-depth examination of recipients' experience of kidney paired donation, with a focus on psychosocial adjustment. <b>Methods/Approach:</b> Individual interviews were conducted with 8 recipients who received a transplant through Canada's Kidney Paired Donation program. Data was analyzed using Interpretative Phenomenological Analysis. <b>Findings:</b> Four themes emerged: (a) an emotionally charged relationship with the known donor, (b) optimal distance regulation in the relationship with the anonymous donor, (c) kidney paired donation as a series of ups and downs, and (d) multilayered gratitude. <b>Discussion:</b> Findings are considered in relation to extant literature. Issues relevant to the transplant community's clinical and research efforts to provide kidney recipients responsive care are discussed.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"35-40"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/26/10.1177_15269248211064881.PMC8918868.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39788550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematized Review of Professional Employment Following Thoracic Transplantation.","authors":"Stefan Jobst,&nbsp;Jonas Schaefer,&nbsp;Christina Kleiser,&nbsp;Christiane Kugler","doi":"10.1177/15269248211064883","DOIUrl":"https://doi.org/10.1177/15269248211064883","url":null,"abstract":"<p><strong>Introduction: </strong>Acknowledging the evolved landscape in thoracic transplantation, professional employment becomes an important outcome measure to quantify the success of this costly procedure.</p><p><strong>Objective: </strong>We aimed to assess rates of and characterize factors associated with professional employment in patients following thoracic transplantation, and create an evidence-base on the relationship between professional employment and relevant outcome parameters.</p><p><strong>Methods: </strong>We systematically searched Medline, Cinahl, and GoogleScholar to identify studies published between 1998 and 2021 reporting on professional employment following heart and lung transplantation.</p><p><strong>Results: </strong>Twenty-two studies from 11 countries with varying sample sizes (N = 27; 10 066) were included. Employment rates ranged from 19.7% to 69.4% for heart, and from 7.4% to 50.8% for lung transplant recipients. Most frequently reported positively associated factors with employment after transplant were younger age, higher education, and history of pretransplant employment. Longer duration of unemployment prior to transplantation and Medicaid coverage were the most frequently reported negatively associated factors. Relationships between professional employment and clinical outcomes included lower rates of acute and chronic rejection, less infection episodes, and better quality of life among working patients; one study reported a lower 5-year-mortality rate. Reasons not to work were \"physical or mental health-related,\" \"employment-related,\" \"financial reasons,\" and \"lifestyle choices.\"</p><p><strong>Discussion: </strong>Substantial proportions of patients following thoracic transplantation are not professionally employed, potentially diminishing the success of transplantation on individual and societal levels. Considering adverse clinical outcomes in employed transplant recipients were low, more efforts are needed to identify modifiable factors for employment in these populations.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"55-66"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39916204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}