Transplantation Reviews最新文献

{"title":"Trends in systematic reviews of kidney transplantation: A 10-year analysis of the evidence base","authors":"Sarah Salih ,&nbsp;John O'Callaghan ,&nbsp;Marwah Salih ,&nbsp;James Walker ,&nbsp;Reshma Rana Magar ,&nbsp;Simon Knight ,&nbsp;Liset H.M. Pengel","doi":"10.1016/j.trre.2023.100759","DOIUrl":"10.1016/j.trre.2023.100759","url":null,"abstract":"<div><h3>Background</h3><p>Systematic reviews (SRs) are the highest form of evidence for all types of clinical questions in evidence-based practice. For the first time in 2018, the number of SRs in transplantation outstripped those from randomised controlled trials (RCTs). This raises concerns of duplication or increased use of non-RCT evidence. We aimed to analyse the trends, strength and quality of SRs in kidney transplantation over a 10-year period.</p></div><div><h3>Methods</h3><p>SRs in kidney transplantation were identified from the Transplant Library, without language restriction. All full-text citations were exported to a custom Research Electronic Data Capture (REDCap) database prior to evaluation. Quality of evidence in all included SRs was assessed using AMSTAR-2.</p></div><div><h3>Results</h3><p>We included 454 SRs, of which, only three were scored as ‘high quality’. We found that 96.70% of SRs were identified as ‘critically low quality’, which increased in number over time. We also found that inclusion of non-RCT data increased in the most recent 5 years. Only 14.12% of SRs had made a clear recommendation for practice.</p></div><div><h3>Conclusions</h3><p>This review highlights several concerning statistics that need to be addressed. In the last 10 years, only three SRs in kidney transplantation were ‘high-quality’. The weaknesses identified in critical domains, alongside the increased use of non-RCT data and lack of conclusive recommendations undermines the confidence in the results of the SRs and purpose of publication. As these SRs are instrumental to clinical decision-making and patient care in kidney transplantation, we advocate for improved reporting quality among SRs in kidney transplantation.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 2","pages":"Article 100759"},"PeriodicalIF":4.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10034305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can eHealth applications improve renal transplant outcomes for adolescents and young adults? A systematic review","authors":"Kim C.M. Bul ,&nbsp;Christopher Bannon ,&nbsp;Nithya Krishnan ,&nbsp;Amber Dunlop ,&nbsp;Ala Szczepura","doi":"10.1016/j.trre.2023.100760","DOIUrl":"10.1016/j.trre.2023.100760","url":null,"abstract":"<div><h3>Background and Objectives</h3><p>Adherence to medical treatment following a kidney transplant is particularly challenging during adolescence and young adulthood.</p><p>There is increasing evidence of the benefits of the use of computer and mobile technology (labelled as eHealth hereafter) including serious gaming and gamification in many clinical areas. We aimed to conduct a systematic review of such interventions designed to improve self-management skills, treatment adherence and clinical outcomes in young kidney transplant recipients aged 16 to 30 years.</p></div><div><h3>Method</h3><p>The Cochrane Library, MEDLINE, EMBASE, PsychINFO, SCOPUS and CINAHL databases were searched for studies published between 01 January 1990 and 20 October 2020. Articles were short-listed by two independent reviewers based on pre-defined inclusion/exclusion criteria. Reference lists were screened and authors of published conference abstracts contacted. Two reviewers independently appraised selected articles, systematically extracted data and assessed the quality of individual studies (CASP and SORT). Thematic analysis was used for evidence synthesis; quantitative meta-analysis was not possible.</p></div><div><h3>Results</h3><p>A total of 1098 unique records were identified. Short-listing identified four eligible studies, all randomized controlled trials (<em>n</em> = 266 participants). Trials mainly focused on mHealth applications or electronic pill dispensers (mostly for patients &gt;18 years old). Most studies reported on clinical outcome measures. All showed improved adherence but there were no differences in the number of rejections. Study quality was low for all four studies.</p></div><div><h3>Conclusions</h3><p>The findings of this review suggest that eHealth interventions can improve treatment adherence and clinical outcomes for young kidney transplant patients. More robust and high-quality studies are now needed to validate these findings. Future studies should also extend beyond short-term outcomes, and consider cost of implementation. The review was registered with PROSPERO (CRD42017062469).</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 2","pages":"Article 100760"},"PeriodicalIF":4.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9681949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, predictors and outcomes of new onset systolic heart failure following orthotopic liver transplant: A systematic review","authors":"Amrin Kharawala ,&nbsp;Israel Safiriyu ,&nbsp;Adebolu Olayinka ,&nbsp;Adrija Hajra ,&nbsp;Jiyoung Seo ,&nbsp;Harriet Akunor ,&nbsp;Majd Al Deen Alhuarrat ,&nbsp;Rosy Thachil","doi":"10.1016/j.trre.2023.100758","DOIUrl":"10.1016/j.trre.2023.100758","url":null,"abstract":"<div><h3>Background</h3><p>New onset Systolic heart failure<span> (SHF), characterized by new onset left ventricular (LV) systolic dysfunction with a reduction in ejection fraction<span> (EF) of &lt;40%, is a common cause of morbidity and mortality among Orthotopic liver transplant (OLT) recipients. Therefore, we aimed to evaluate the prevalence, the pre-transplant predictors, and the prognostic impact of SHF post-OLT.</span></span></p></div><div><h3>Methods</h3><p>We conducted a systematic review of the literature using electronic databases MEDLINE, Web of Science, and Embase for studies reporting acute systolic heart failure post-liver transplant from inception to August 2021.</p></div><div><h3>Result</h3><p>Of 2604 studies, 13 met the inclusion criteria and were included in the final systematic review. The incidence of new-onset SHF post OLT ranged from 1.2% to 14%. Race, sex, or body mass index<span><span><span> did not significantly impact the post-OLT SHF incidence. Alcoholic liver cirrhosis<span>, pre-transplant systolic or diastolic dysfunction, troponin, </span></span>brain natriuretic peptide<span> (BNP), blood urea nitrogen<span> (BUN) elevation, and hyponatremia<span> were noted to be significantly associated with the development of SHF post-OLT. The significance of MELD score in the development of post-OLT SHF is controversial. Pre-transplant beta-blocker and post-transplant tacrolimus use were associated with a lower risk of developing SHF. The average 1-year mortality rate </span></span></span></span>in patients with SHF post-OLT ranged from 0.00% to 35.2%.</span></p></div><div><h3>Conclusion</h3><p>Despite low incidence, SHF post-OLT can lead to higher mortality. Further studies are required to fully understand the underlying mechanism and risk factors.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 2","pages":"Article 100758"},"PeriodicalIF":4.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9731975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives and experiences of kidney transplant recipients with graft failure: A systematic review and meta-synthesis","authors":"Katya Loban ,&nbsp;Anna Horton ,&nbsp;Jorane-Tiana Robert ,&nbsp;Lindsay Hales ,&nbsp;Sandesh Parajuli ,&nbsp;Mara McAdams-DeMarco ,&nbsp;Shaifali Sandal","doi":"10.1016/j.trre.2023.100761","DOIUrl":"10.1016/j.trre.2023.100761","url":null,"abstract":"<div><h3>Background</h3><p><span>Kidney transplant recipients with </span>graft failure are a rapidly rising cohort of patients who experience high morbidity, mortality, and fragmented transitions of care between transplant and dialysis teams. Current approaches to improving care focus on medical and surgical interventions, increasing re-transplantation, and improving coordination between treating teams with little understanding of patient needs and perspectives.</p></div><div><h3>Methods</h3><p>We undertook a systematic literature review of personal experiences of patients with graft failure. Six electronic and five grey literature databases were searched systematically. Of 4664 records screened 43 met the inclusion criteria. Six empirical qualitative studies and case studies were included in the final analysis. Thematic synthesis was used to combine data that included the perspectives of 31 patients with graft failure and 9 caregivers.</p></div><div><h3>Results</h3><p>Using the Transition Model, we isolated three interconnected phases as patients transition through graft failure: shattering of lifestyle and plans associated with a successful transplant; physical and psychological turbulence; and re-alignment by learning adaptive strategies to move forward. Critical factors affecting coping included multi-disciplinary healthcare approaches, social support, and individual-level factors. While clinical transplant care was evaluated positively, participants identified gaps in the provision of information and psychosocial support related to graft failure. Graft failure had a profound impact on caregivers especially when they were living donors.</p></div><div><h3>Conclusions</h3><p>Our review reports patient-identified priorities for improving care and can help inform research and guideline development that strives to improve the care of patients with graft failure.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 2","pages":"Article 100761"},"PeriodicalIF":4.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9681939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventilation during ex vivo lung perfusion, a review","authors":"Sue A. Braithwaite ,&nbsp;Elise van Hooijdonk ,&nbsp;Niels P. van der Kaaij","doi":"10.1016/j.trre.2023.100762","DOIUrl":"10.1016/j.trre.2023.100762","url":null,"abstract":"<div><p>Evidence suggests that ventilation during ex vivo lung perfusion (EVLP) with a ‘one-size-fits-all’ strategy has the potential to cause lung injury which may only become clinically relevant in marginal lung allografts. EVLP induced- or accelerated lung injury is a dynamic and cumulative process reflecting the interplay of a number of factors. Stress and strain in lung tissue caused by positive pressure ventilation may be exacerbated by the altered properties of lung tissue in an EVLP setting. Any pre-existing injury may alter the ability of lung allografts to accommodate set ventilation and perfusion techniques on EVLP leading to further injury.</p><p>This review will examine the effects of ventilation on donor lungs in the setting of EVLP. A framework for developing a protective ventilation technique will be proposed.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 2","pages":"Article 100762"},"PeriodicalIF":4.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9731987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with health inequities in access to kidney transplantation in the USA: A scoping review","authors":"Zachary Ernst ,&nbsp;Andrew Wilson ,&nbsp;Andriana Peña ,&nbsp;Mitchell Love ,&nbsp;Ty Moore ,&nbsp;Matt Vassar","doi":"10.1016/j.trre.2023.100751","DOIUrl":"10.1016/j.trre.2023.100751","url":null,"abstract":"<div><h3>Background</h3><p>The kidney is the most needed organ for transplantation in the United States. However, demand and scarcity of this organ has caused significant inequities for historically marginalized groups. In this review, we report on the frequency of inequities in all steps of kidney transplantation from 2016 to 2022. Search criteria was based on the National Institute of Health's (NIH) 2022 list of populations who experience health inequities, which includes: race and ethnicity; sex or gender; Lesbian, Gay, Bisexual, Transgender, Queer + (LGBTQ+); underserved rural communities; education level; income; and occupation status. We outline steps for future research aimed at assessing interventions and programs to improve health outcomes.</p></div><div><h3>Methods</h3><p>This scoping review was developed following guidelines from the Joanna Briggs Institute and PRISMA extension for scoping reviews. In July 2022, we searched Medline (via PubMed) and Ovid Embase databases to identify articles addressing inequities in access to kidney transplantation in the United States. Articles had to address at least one of the NIH's 2022 health inequity groups.</p></div><div><h3>Results</h3><p>Our sample of 44 studies indicate that Black race, female sex or gender, and low socioeconomic status are negatively associated with referral, evaluation, and waitlisting for kidney transplantation. Furthermore, only two studies from our sample investigated LGBTQ+ identity since the NIH's addition of SGM in 2016 regarding access to transplantation. Lastly, we found no detectable trend in studies for the four most investigated inequity groups between 2016 and 2022.</p></div><div><h3>Conclusion</h3><p>Investigations in inequities for access to kidney transplantation for the two most studied groups, race/ethnicity and sex or gender, have shown no change in frequencies. Regarding race and ethnicity, continued interventions focused on educating Black patients and staff of dialysis facilities may increase transplant rates. Studies aimed at assessing effectiveness of the Kidney Paired Donation program are highly warranted due to incompatibility problems in female patients. The sparse representation for the LGBTQ+ population may be due to a lack of standardized data collection for sexual orientation. We recommend this community be engaged via surveys and further investigations.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 2","pages":"Article 100751"},"PeriodicalIF":4.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9681483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The short- and long-term outcomes in living-donor liver transplantation using small-for-size graft: A systematic review and meta-analysis","authors":"Ki-Hun Kim,&nbsp;Sang-Hoon Kim,&nbsp;Hwui-Dong Cho","doi":"10.1016/j.trre.2023.100747","DOIUrl":"10.1016/j.trre.2023.100747","url":null,"abstract":"<div><h3>Background</h3><p>A standard graft-to-recipient weight ratio (GRWR) ≥0.8% is widely accepted in living-donor liver transplantation (LDLT); however, the potential donor pool is expanded to patients adopting small-for-size graft (SFSGs) with GRWR &lt;0.8%. This study aimed to investigate the effect of SFSG on short- and long-term outcomes following LDLT.</p></div><div><h3>Methods</h3><p>Electronic databases were searched from January 1995 to January 2022 for studies comparing short- or long-term outcomes between patients with SFSG (GRWR &lt;0.8%, SFSG group) and sufficient volume graft (GRWR ≥0.8%, non-SFSG group). The primary outcomes were one-, three-, and five-year overall survival (OS) and graft survival<span> (GS), while the secondary outcome was postoperative complications.</span></p></div><div><h3>Results</h3><p>Twenty-four studies comprising 7996 patients were included. In terms of OS, SFSG group had poor three-year OS (HR: 1.48, 95% CI [1.01, 2.15], <em>p</em> = 0.04), but there were no significant differences between two groups in one-year OS (HR: 1.50, 95% CI [0.98, 2.29], <em>p</em> = 0.06) and five-year OS (HR: 1.40, 95% CI [0.95, 2.08], <em>p</em> = 0.02). In GS, there were no significant differences in one-year (HR 1.31, 95% CI [1.00, 1.72], <em>p</em> = 0.05), three-year (HR 1.33, 95% CI [0.97, 1.82], <em>p</em> = 0.07), and five-year GS (HR 1.17, 95% CI [0.95, 1.44], <em>p</em> = 0.13). The SFSG group had comparable postoperative complications, except for a high incidence of vascular complications and small-for-size syndromes.</p></div><div><h3>Conclusions</h3><p>Expanding the potential donor pool in LDLT to SFSG with GRWR &lt;0.8% can be acceptable in terms of comparable long-term OS and GS, despite the risk for vascular complications and small-for-size syndrome.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 1","pages":"Article 100747"},"PeriodicalIF":4.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9336482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes from organ donation following medical assistance in dying: A scoping review","authors":"Vanessa Silva e Silva ,&nbsp;Amina Silva ,&nbsp;Andrea Rochon ,&nbsp;Ken Lotherington ,&nbsp;Laura Hornby ,&nbsp;Tineke Wind ,&nbsp;Jan Bollen ,&nbsp;Lindsay C. Wilson ,&nbsp;Aimee J. Sarti ,&nbsp;Sonny Dhanani","doi":"10.1016/j.trre.2023.100748","DOIUrl":"10.1016/j.trre.2023.100748","url":null,"abstract":"<div><h3>Aim</h3><p>To collate and summarize the current international literature on the transplant recipient outcomes of organs from Medical Assistance in Dying (MAiD) donors, as well as the actual and potential impact of organ donation following MAiD on the donation and transplantation system.</p></div><div><h3>Background</h3><p>The provision of organ donation following MAiD can impact the donation and transplantation system, as well as potential recipients of organs from the MAiD donor, therefore a comprehensive understanding of the potential and actual impact of organ donation after MAiD on the donation and transplantation systems is needed.</p></div><div><h3>Design</h3><p>Scoping review using the JBI framework.</p></div><div><h3>Methods</h3><p>We searched for published (MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Academic Search Complete), and unpublished literature (organ donation organization websites worldwide). Included references discussed the actual and potential impact of organ donation following MAiD on the donation and transplantation system. All references were screened, extracted and analysed by two independent reviewers.</p></div><div><h3>Results</h3><p>We included 78 references in this review and our finding were summarized across three categories: (1) Impact in the donor pool: (2) statistics on organ donation following MAiD; and (3) potential and actual impact of MAiD on the donation and transplant system.</p></div><div><h3>Conclusions</h3><p>The potential impact of the MAiD donor on the transplant waiting list is relatively small as this process is still rare, however, due to the current organ shortage worldwide the contribution of this procedure should not be disregarded. Additionally, despite being limited, the existing research provided scanty evidence that organs retrieved from MAiD donors are associated with satisfactory graft function and survival rates and that outcomes from transplant recipients are comparable to those of organs from donation following brain death and may be better than those of organs from other types of donation after circulatory determined death. Still, further studies are required for comprehensive and reliable evidence.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 1","pages":"Article 100748"},"PeriodicalIF":4.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9341172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of live renal donors with a history of nephrolithiasis; A systematic review","authors":"Mohamed Eftal Bin Mohamed Ebrahim ,&nbsp;Animesh Singla ,&nbsp;Jinna Yao ,&nbsp;Jerome Martin Laurence ,&nbsp;Germaine Wong ,&nbsp;Howard Lau ,&nbsp;Taina Lee ,&nbsp;Lawrence Yuen ,&nbsp;Wai H. Lim ,&nbsp;Henry Pleass","doi":"10.1016/j.trre.2022.100746","DOIUrl":"10.1016/j.trre.2022.100746","url":null,"abstract":"<div><p><span><span>The clinical outcomes of kidney donors with a prior history of nephrolithiasis are poorly defined. We conducted a </span>systematic review assessing the post-donation clinical outcomes of kidney donors with a history of nephrolithiasis. Electronic databases </span><strong>(</strong><span>Ovid and Embase) were searched between 1960 and 2021 using key terms and Medical Subject Headings (MeSH) – nephrolithiasis, renal stones, renal transplantation<span> and renal graft<span>. Articles included conference proceedings and journal articles and were not excluded based on patient numbers. Primary outcome was donor stone-related event. Secondary outcomes were renal function upon follow-up or post-operative nephrectomy complications. In summary, 340 articles were identified through database search. We identified 14 studies (16 cohorts) comprising 432 live donors followed up for a median of 26 months post live kidney donation. Six donors donated the stone-free kidney whilst 23 live donors had bilateral stones. Mean stone size was 4.2 ± 1.4 mm (1–16) with average follow up duration of 21.1 months (1–149). Twelve studies provided primary outcome (</span></span></span><em>n</em> = 138 patients) and eight (<em>n</em><span> = 348) for secondary outcomes. One donor had a stone-related event upon follow up. A total of 195 patients had eGFR &lt;60 upon follow up. However, they were not significantly different when compared to renal function of live donors that didn't have pre-donation nephrolithiasis. Many of the studies couldn't provide long term follow up, coupled with limited data regarding the nature of the pre-donation stone disease. In conclusion, this systematic review shows that we have very limited information upon which to base recommendation regarding pre-donation risk of post-donation complications. Longer term follow up is required and lifelong follow up with live donor registries will aid further understanding.</span></p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 1","pages":"Article 100746"},"PeriodicalIF":4.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9691004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best practices during COVID-19 pandemic in solid organ transplant programs in Spain","authors":"Julio Pascual ,&nbsp;Auxiliadora Mazuecos ,&nbsp;Gloria Sánchez-Antolín ,&nbsp;Amparo Solé ,&nbsp;Pedro Ventura-Aguiar ,&nbsp;Marta Crespo ,&nbsp;Marta Farrero ,&nbsp;Constantino Fernández-Rivera ,&nbsp;Iris P. Garrido ,&nbsp;Francisco Gea ,&nbsp;Esther González-Monte ,&nbsp;Antonio González-Rodríguez ,&nbsp;Román Hernández-Gallego ,&nbsp;Carlos Jiménez ,&nbsp;Verónica López-Jiménez ,&nbsp;Alejandra Otero ,&nbsp;Sonia Pascual ,&nbsp;Gonzalo P. Rodríguez-Laiz ,&nbsp;Juan Carlos Ruiz ,&nbsp;Asunción Sancho ,&nbsp;Juan F. Delgado","doi":"10.1016/j.trre.2023.100749","DOIUrl":"10.1016/j.trre.2023.100749","url":null,"abstract":"<div><p>Clinical management of transplant patients abruptly changed during the first months of COVID-19 pandemic (March to May 2020). The new situation led to very significant challenges, such as new forms of relationship between healthcare providers and patients and other professionals, design of protocols to prevent disease transmission and treatment of infected patients, management of waiting lists and of transplant programs during state/city lockdown, relevant reduction of medical training and educational activities, halt or delays of ongoing research, etc.</p><p>The two main objectives of the current report are: 1) to promote a project of best practices in transplantation taking advantage of the knowledge and experience acquired by professionals during the evolving situation of the COVID-19 pandemic, both in performing their usual care activity, as well as in the adjustments taken to adapt to the clinical context, and 2) to create a document that collects these best practices, thus allowing the creation of a useful compendium for the exchange of knowledge between different Transplant Units.</p><p>The scientific committee and expert panel finally standardized 30 best practices, including for the pretransplant period (<em>n</em> = 9), peritransplant period (<em>n</em> = 7), postransplant period (<em>n</em> = 8) and training and communication (<em>n</em> = 6). Many aspects of hospitals and units networking, telematic approaches, patient care, value-based medicine, hospitalization, and outpatient visit strategies, training for novelties and communication skills were covered.</p><p>Massive vaccination has greatly improved the outcomes of the pandemic, with a decrease in severe cases requiring intensive care and a reduction in mortality. However, suboptimal responses to vaccines have been observed in transplant recipients, and health care strategic plans are necessary in these vulnerable populations. The best practices contained in this expert panel report may aid to their broader implementation.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 1","pages":"Article 100749"},"PeriodicalIF":4.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9392630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}