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

{"title":"Ventilator autotriggering: a caution in brain death diagnosis.","authors":"Rebecca Dodd-Sullivan,&nbsp;Jamie Quirin,&nbsp;John Newhart","doi":"10.1177/152692481102100211","DOIUrl":"https://doi.org/10.1177/152692481102100211","url":null,"abstract":"<p><p>The Uniform Determination of Death Act and the American Academy of Neurology's Guidelines for Determination of Death define procedures for diagnosis of brain death before organ procurement for transplantation, including clinical assessment and apnea test. Autotriggering of mechanical ventilators can occur in both brain dead and living patients. A case is reported in which procurement was delayed because ventilator self-cycling was confused for brainstem-mediated respiratory effort. Background knowledge to effectively troubleshoot ventilator self-cycling is offered so that unnecessary delays in brain death testing can be avoided.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"152-5"},"PeriodicalIF":0.8,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152692481102100211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29990199","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":"Collaborative use of the peer assist model in large transplant programs in the United States.","authors":"Amy S Peele,&nbsp;Stefanie Goldberg,&nbsp;Joyce A Trompeta","doi":"10.1177/152692481102100207","DOIUrl":"https://doi.org/10.1177/152692481102100207","url":null,"abstract":"<p><strong>Context: </strong>The basic assumption of the peer assist model is that nearly every transplant center is already doing something that other centers could adopt in order to streamline or enhance their own operations.</p><p><strong>Objective: </strong>To describe how the Transplant Growth and Management Collaborative used the peer assist model with 2 large transplant centers in the United States and to identify best practices and outcomes.</p><p><strong>Setting: </strong>The University of California, San Francisco, Medical Center.</p><p><strong>Participants: </strong>Transplant health care providers (surgeons, nurse transplant coordinators) and administrative staff (program directors, financial advisers, quality representatives).</p><p><strong>Intervention: </strong>The peer assist model is a mechanism by which a transplant center receives feedback about a specific topic from another transplant center that encountered similar issues and developed effective action plans for overcoming barriers to success; it is a reciprocal model in which knowledge is shared.</p><p><strong>Results: </strong>The peer assist model benefited the preparation for accelerated growth in 2 of the largest transplant centers in the United States. The collaboration during peer assist visits is an opportune time for transplant centers to learn from one another.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"124-30"},"PeriodicalIF":0.8,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152692481102100207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29990195","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":"From insiders' perspectives: adjusting to caregiving for patients with left ventricular assist devices.","authors":"Linda Marcuccilli,&nbsp;Jesus M Casida","doi":"10.1177/152692481102100209","DOIUrl":"https://doi.org/10.1177/152692481102100209","url":null,"abstract":"<p><strong>Context: </strong>Caregivers for patients with a long-term implantable left ventricular assist device have a very important role in helping patients maintain their health and well-being and attain an improved quality of life. Although the caregiving tasks, burdens, and challenges of family caregivers have been described in the literature, we know little about how caregivers adjust to or accommodate the new role in their lives.</p><p><strong>Objective: </strong>To explore and describe the lifestyle adjustments of caregivers for adults living with a left ventricular assist device as a bridge to heart transplant or destination therapy.</p><p><strong>Design: </strong>A hermeneutic phenomenology was used as a guide for interviews and analysis of the data.</p><p><strong>Participants: </strong>A purposive convenience sample of 5 women, aged 39 to 71 years, who had served as caregivers of a left ventricular assist device patient for at least 3 months.</p><p><strong>Setting: </strong>Recruitment and data collection (interviews) were conducted in an outpatient clinic for the mechanical circulatory support program of a large academic medical center in the Midwest.</p><p><strong>Results: </strong>Three main themes (caregiving: a \"24/7\" responsibility, coping strategies, and satisfaction) and 13 subthemes emerged from the data.</p><p><strong>Conclusions: </strong>Lifestyle adjustments with caregiving may become easier over time, and with effective use of coping strategies, caregivers accept their new caregiving role as part of life.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"137-43"},"PeriodicalIF":0.8,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152692481102100209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29990197","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":"Women in transplantation: an interview with Patricia Adams, MD.","authors":"Linda Ohler","doi":"10.1177/152692481102100201","DOIUrl":"https://doi.org/10.1177/152692481102100201","url":null,"abstract":"","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"92-3"},"PeriodicalIF":0.8,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152692481102100201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29989816","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":"Measurement of cardiac output during adult donor care.","authors":"David J Powner,&nbsp;Georgene W Hergenroeder","doi":"10.1177/152692481102100210","DOIUrl":"https://doi.org/10.1177/152692481102100210","url":null,"abstract":"<p><p>Measurement of cardiac output may improve hemodynamic management in donor care. Selected traditional and more recent methods to quantify cardiac output are reviewed. The accuracy or concordance of these newer methods when compared with thermodilution techniques that use a pulmonary artery catheter-the current reference standard-is discussed. Data directly comparing these systems for measuring cardiac output in the donor population are unavailable. However, data from groups of hemodynamically unstable patients favor selection of a measurement method that permits comparison (calibration) with a reference standard. A prospective comparison of all methods against the pulmonary artery catheter thermodilution technique among donors would provide the best data to resolve this clinical and potentially cost-important question.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"144-50; quiz 151"},"PeriodicalIF":0.8,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152692481102100210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29990198","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":"Sleep and daytime sleepiness of patients with left ventricular assist devices: a longitudinal pilot study.","authors":"Jesus M Casida,&nbsp;Jean E Davis,&nbsp;Robert J Brewer,&nbsp;Cheryl Smith,&nbsp;Hossein Yarandi","doi":"10.1177/152692481102100208","DOIUrl":"https://doi.org/10.1177/152692481102100208","url":null,"abstract":"<p><strong>Context: </strong>No empirical longitudinal data on sleep and daytime sleepiness patterns in patients with an implantable left ventricular assist device (LVAD) exist.</p><p><strong>Objective: </strong>(1) To describe the sleep patterns (sleep onset latency, sleep efficiency, sleep fragmentation index, total sleep time, and wake after sleep onset), sleep quality, and daytime sleepiness variables and (2) to determine the change in the pattern of these variables before and up to 6 months after LVAD implantation.</p><p><strong>Design: </strong>A longitudinal descriptive repeated-measures design was used. Patients wore wrist actigraphs (AW64 Actiwatch), which objectively measured sleep, for 3 consecutive days and nights before LVAD implant and at the first and second week and first, third, and sixth month after implantation. During these periods, patients also completed questionnaires on sleep quality and daytime sleepiness. Patients-Twelve of 15 patients completed the 6-month data. Data were analyzed by using descriptive statistics and repeated-measures analysis of variance.</p><p><strong>Results: </strong>We found long sleep onset latencies and low sleep efficiency across time periods. High sleep fragmentation index was noted at baseline and 1 week after LVAD. Short total sleep times, long wake-after-sleep-onset durations, and poor sleep quality were evident at baseline and persisted up to 6 months after LVAD implantation. Low alertness level, a manifestation of sleepiness, was common during late morning to early evening hours. However, only sleep efficiency and wake after sleep onset showed significant changes in pattern (P < .05).</p><p><strong>Conclusion: </strong>Sleep disturbance and daytime sleepiness may be prevalent before and up to 6 months after LVAD implantation, warranting further investigation.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"131-6"},"PeriodicalIF":0.8,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152692481102100208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29990196","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":"Capnocytophagia canimorsus sepsis in an asplenic heart transplant candidate with a left ventricular assist system.","authors":"Christopher R Ensor,&nbsp;Stuart D Russell,&nbsp;Ilan S Wittstein,&nbsp;John V Conte","doi":"10.1177/152692481102100206","DOIUrl":"https://doi.org/10.1177/152692481102100206","url":null,"abstract":"<p><p>Fulminant septic shock associated with Capnocytophagia canimorsus bacteremia developed in a 54-year-old asplenic man, a heart transplantation candidate who was supported with a HeartMate II left ventricular assist system, after he experienced a dog bite. He improved after administration of broad-spectrum antibiotics, which were narrowed to ampicillin/sulbactam for a prolonged 6-week course, and subsequently recovered fully.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"121-3"},"PeriodicalIF":0.8,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152692481102100206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29990194","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":"\"It has its ups and downs\": adolescents' quality of life after heart transplantation.","authors":"Angela Green,&nbsp;Julie Meaux,&nbsp;Amy Huett,&nbsp;Kathy Ainley","doi":"10.1177/152692481102100205","DOIUrl":"https://doi.org/10.1177/152692481102100205","url":null,"abstract":"<p><strong>Context: </strong>Heart transplantation is not curative and results in a high-morbidity chronic illness. Despite this, little research has focused on adolescents' quality of life after heart transplant. Such research is critically needed because of the complex developmental changes experienced by adolescents and the need for transition to self-management during this vulnerable period.</p><p><strong>Objective: </strong>To examine adolescents' perceptions of their quality of life and factors affecting it.</p><p><strong>Design: </strong>Focused ethnography.</p><p><strong>Setting and participants: </strong>Fourteen adolescents (mean age, 17 years) who had received a heart transplant at least 6 months earlier were recruited from a large children's hospital. The ethnically diverse sample (7 black, 5 white, 1 Asian, and 1 Hispanic) included 8 females and 6 males. Data Collection and Analysis-The adolescents participated in audio-taped qualitative interviews, which were transcribed verbatim and entered into Ethnograph to assist with data management. Thematic analysis was used to identify recurrent themes.</p><p><strong>Results: </strong>Participants described life after transplant by saying, \"It has its ups and downs\". Major themes included these: (1) I am normal and I am not normal, (2) I am grateful and I am resentful, and (3) I am managing and I am not managing. The themes reflect the dichotomous nature of the adolescents' experiences and provide insight into the complex needs of adolescents after heart transplant.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"115-20"},"PeriodicalIF":0.8,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152692481102100205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29990193","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":"Patients' sex and emotional support as predictors of death and clinical deterioration in the waiting for a new heart study: results from the 1-year follow-up.","authors":"Gerdi Weidner,&nbsp;Daniela Zahn,&nbsp;Nancy R Mendell,&nbsp;Jacqueline M A Smits,&nbsp;Mario C Deng,&nbsp;Armin Zittermann,&nbsp;Heike Spaderna","doi":"10.1177/152692481102100204","DOIUrl":"https://doi.org/10.1177/152692481102100204","url":null,"abstract":"<p><strong>Context: </strong>Little is known about the role of patient's sex and emotional support in the prognosis of heart transplant candidates.</p><p><strong>Objective: </strong>To examine patient's sex and emotional support as predictors of outcomes in the Waiting for a New Heart Study.</p><p><strong>Design, setting, and participants: </strong>The Waiting for a New Heart Study is a prospective observational study of 318 patients (18% female) newly added to the waiting list for a heart transplant. Demographic, medical, psychosocial characteristics (including social support [ENRICHD Social Support Index; high vs. low support]) were assessed at the time of wait-listing. Main Outcomes-Time until death/delisting due to deteriorated tealth, considering competing outcomes (e.g., transplantation) during the first 12 months after wait-listing were analyzed via cause-specific Cox proportional hazard models.</p><p><strong>Results: </strong>By 12 months, 32 men (12%) and 10 women (17%) had died/deteriorated. Medical risk was comparable across sexes. More men than women reported low emotional support (20.4% vs. 8.6%) and being a past or current smoker (80.4% vs. 56.9%). More women than men had low vocational level (93.1% vs. 69.6%; all P values < .05). With medical risk and other confounding variables controlled for, female sex significantly increased risk of death/deterioration (hazard ratio, 2.30; 95% confidence interval, 1.04-5.12; P = .04); low emotional support further tended to increase the risk for this outcome (P = .07). As none of the 5 women with low emotional support had reached this end point, analyses were performed in the male sample and revealed that men with low emotional support were more than twice as likely to die/deteriorate than were men with high support (hazard ratio, 2.23; 95% confidence interval, 1.04-4.82; P = .04).</p><p><strong>Conclusion: </strong>Women had worse survival while awaiting a heart transplant than men had, independent of confounding variables. Even though emotional support may be an important buffer for men, protective factors for women warrant further investigation with larger samples and/or longer follow-ups.</p>","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"106-14"},"PeriodicalIF":0.8,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152692481102100204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29990192","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":"Numbers.","authors":"Jessica Hautsch","doi":"10.1177/152692480701700313","DOIUrl":"https://doi.org/10.1177/152692480701700313","url":null,"abstract":"","PeriodicalId":346415,"journal":{"name":"Progress in Transplantation (Aliso Viejo, Calif.)","volume":" ","pages":"241-2"},"PeriodicalIF":0.8,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152692480701700313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41036393","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}