Life satisfaction and adverse effects in renal transplant recipients: a longitudinal analysis

Matas, Arthur J.; Halbert, Ronald J.; Barr, Mark L.; Helderman, J. Harold; Hricik, Donald E.; Pirsch, John D.; Schenkel, Felicia A.; Siegal, B; Liu, Honghu; Ferguson, Ronald M.

doi:10.1034/j.1399-0012.2002.1o126.x

Cited by 115 publications

(103 citation statements)

References 28 publications

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“…Because comorbidity is not the sole determinant of transplant outcome, approaches such as the one detailed in a recent article by Krakauer et al (20), which incorporate components such as psychologic factors, disability, and resource use in a more comprehensive model for clinical decision making, may be more appropriate in developing policies that govern distribution of donor organs. However, comorbid conditions are common in transplant recipients and have a significant impact on posttransplantation quality of life (37); thus, continued assessment of comorbidity provides an opportunity to identify issues that are essential for optimizing the continued care of kidney transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

Comorbid Conditions in Kidney Transplantation

Wu¹,

Evans²,

Joseph³

et al. 2005

Journal of the American Society of Nephrology

146

101

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Although the impact of comorbidity on outcomes in ESRD has been evaluated extensively, its contribution after kidney transplantation has not been well studied. It is believed that comorbidity assessment is critical to the informed interpretation of kidney transplant outcomes. In this study, the Charlson Comorbidity Index was used to assess the comorbid conditions of 715 patients who underwent kidney transplantation at the Starzl Transplant Institute between January 1998 and January 2003. The impact of pretransplantation comorbidity on the development of acute cellular rejection after transplantation and on patient and graft survival was examined. The most common comorbid conditions among our patient population were diabetes (n ‫؍‬ 217, 30.3%) and heart failure (n ‫؍‬ 85, 11.9%). It was found the number of patients with high comorbidity at the Starzl Transplant Institute has increased significantly over time (P ‫؍‬ 0.04). In multivariate adjusted models, high comorbidity was associated with an increased risk for patient death, both in the perioperative period (hazard ratio 3.20, 95% confidence interval 1.32 to 7.78; P ‫؍‬ 0.01) and >3 mo after transplantation (hazard ratio 2.63; 95% confidence interval 1.62 to 4.28; P < 0.001). The Charlson Comorbidity Index is a practical tool for the evaluation of comorbidity in the transplant population, which has an increasing burden of comorbid disease. Increased comorbidity affects both perioperative and long-term patient outcomes and carries significant implications not only for the development of individual patient therapeutic strategies but also for the interpretation of patient trials and the development of policies that govern distribution of donor organs.

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Section: Discussionmentioning

confidence: 99%

Comorbid Conditions in Kidney Transplantation

Wu¹,

Evans²,

Joseph³

et al. 2005

Journal of the American Society of Nephrology

146

101

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“…Studien visar bland annat på att det hos vissa patienter finns ett emotionellt kaos efter transplantationen, vilket till exempel yttrar sig i en önskan om att "återerövra sin kropp". Även i en undersökning genomförd fem år efter transplantationen påvisas att det finns en stor inverkan av emotionella faktorer efter transplantationen, vilket visar sig i framförallt försämrade sexuella funktioner och relationer (9). Det finns också undersökningar som visar på motsatsen, det vill säga, det är ovanligt med emotionella och psykiska problem en längre tid efter transplantationen (10).…”

Section: Tidigare Forskningunclassified

“…Smärta kan vara ett problem efter transplantationen (9,13). 50 av 120 tillfrågade patienter hade så svår smärta att det gav en negativ påverkan på det dagliga livet, i arbete och övriga aktiviteter upp till tio år efter transplantationen (13).…”

Section: Tidigare Forskningunclassified

“…50 av 120 tillfrågade patienter hade så svår smärta att det gav en negativ påverkan på det dagliga livet, i arbete och övriga aktiviteter upp till tio år efter transplantationen (13). Problem i form av till exempel ledbesvär fanns hos 30% i en utvärdering gjord ungefär fem år efter transplantationen (9). I en studie påvisas svåra smärtor även i samband med transplantationstillfället (8).…”

Section: Tidigare Forskningunclassified

See 1 more Smart Citation

Att bli transplanterad — en studie av patientens upplevelse

Frejd¹,

Nordén²,

Lyckhage³

2008

Nordic Journal of Nursing Research

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Sahlgrenska akademin VID GÖTEBORGS UNIVERSITETInstitutionen för vårdvetenskap och hälsa D-uppsats i Omvårdnad Titel (svensk):Att bli transplanterad -en studie av patientens upplevelse. Titel (engelsk):To be transplantated -a study about the patients' experience. BackgroundEarlier research according studying the experience of being transplanted, either with a kidney or a liver, have focused patients experience three months after the transplantation. Focus in this study is in the first month after the transplantation. From a perspective of "lifeworld" it is important that the integrity and entire life situation of the patient is maintained and protected. To illuminate patients need considering his/her experience of health and suffering during the first month after the transplantation can be a guide for nurses in order to take care for these patients in a way that cant strengthen there wellbeing. PurposeThe purpose was to describe patient´s experience of being transplanted, one month after the surgery. MethodThe study is a interview study. The interviews took place at two occasions during the first month after the transplantation. The interviews were taped and transcribed. The text has been analyzed by a qualitative method where the text after careful reading has been converged into codes according to the context of the text. Consequently the codes have been sorted into categories. Finally categories formed three separate themes. ResultsThe patients show a remarkable confidence in medical care even if the transplantation involved suffering for some of the individual patients. In order to ease the adjustment to the situation for the patient and to preserve the patient's trust in medical care it is important to utilize the knowledge and experience of illness and sub-health of the patient. This would be the best way for following up the situation of the transplant patient. The patient can be given an opportunity to adapt to his/her situation in life if the competence of the nurse as a transmitter of knowledge and as a medical expert is utilized. This will also improve future contacts between the patient and medical care.

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“…However, despite such evidence, many kidney transplant recipients experience adverse effects that affect life satisfaction and QOL (193)(194)(195). Sixty-six percent of kidney transplant recipients reported easy bruising/slow wound healing, 61% noted adverse effects related to sexuality, and Ͼ50% related problems secondary to changes in physical appearance (193,194).…”

Section: Quality Of Life and Nonadherencementioning

confidence: 99%

Medical Care of Kidney Transplant Recipients after the First Posttransplant Year

Djamali

Samaniego²,

Muth³

et al. 2006

Clinical Journal of the American Society of Nephrology

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Kidney transplantation is the treatment of choice for patients with ESRD. Despite improvements in short-term patient and graft outcomes, there has been no major improvement in long-term outcomes. The use of kidney allografts from expandedcriteria donors, polyoma virus nephropathy, underimmunosuppression, and incomplete functional recovery after rejection episodes may play a role in the lack of improvement in long-term outcomes. Other factors, including cardiovascular disease, infections, and malignancies, also shorten patient survival and therefore reduce the functional life of an allograft. There is a need for interventions that improve long-term outcomes in kidney transplant recipients. These patients are a unique subset of patients with chronic kidney disease. Therefore, interventions need to address disease progression, comorbid conditions, and patient mortality through a multifaceted approach. The Kidney Disease Outcomes Quality Initiative from the National Kidney Foundation, the European Best Practice Guidelines, and the forthcoming Kidney Disease: Improving Global Outcomes clinical practice guidelines can serve as a cornerstone of this approach. The unique aspects of chronic kidney disease in the transplant recipient require the integration of specific transplant-oriented problems into this care schema and a concrete partnership among transplant centers, community nephrologists, and primary care physicians. This article reviews the contemporary aspects of care for these patients.

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Life satisfaction and adverse effects in renal transplant recipients: a longitudinal analysis

Cited by 115 publications

References 28 publications

Comorbid Conditions in Kidney Transplantation

Comorbid Conditions in Kidney Transplantation

Att bli transplanterad — en studie av patientens upplevelse

Medical Care of Kidney Transplant Recipients after the First Posttransplant Year

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