Posttransplantation Quality of Life: More Than Graft Function

Habwe, Violet Q.

doi:10.1053/j.ajkd.2005.12.041

Cited by 55 publications

(45 citation statements)

References 45 publications

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“…However, over the same period, long-term patient survival curves have been relatively flat [1,2]. Extending the perspectives of kidney transplant recipients is therefore a profound challenge and an important research priority [3][4][5].A major limiter of long-term survival is the gradual deterioration of kidney graft function [3][4][5][6], resulting from a range of function-impairing problems known collectively as chronic kidney dysfunction. Among the possible cause of chronic kidney dysfunction are behavioural aspects of the medication regimen, such as non adherence to the immunosuppressive prescription [5,7,8].…”

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confidence: 99%

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“…Extending the perspectives of kidney transplant recipients is therefore a profound challenge and an important research priority [3][4][5].…”

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Clinical consequences of non adherence to immunosuppressive medication in kidney transplant patients

Denhaerynck

Burkhalter

Schäfer-Keller

et al. 2009

Transplant International

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In recent decades, improvements in immunosuppressive medication have considerably increased the shortterm life expectancy of transplanted kidneys by reducing the incidence of acute rejections, primarily in the first year post-transplant. However, over the same period, long-term patient survival curves have been relatively flat [1,2]. Extending the perspectives of kidney transplant recipients is therefore a profound challenge and an important research priority [3][4][5].A major limiter of long-term survival is the gradual deterioration of kidney graft function [3][4][5][6], resulting from a range of function-impairing problems known collectively as chronic kidney dysfunction. Among the possible cause of chronic kidney dysfunction are behavioural aspects of the medication regimen, such as non adherence to the immunosuppressive prescription [5,7,8]. Next to the observation that non adherence has been linked to increased serum creatinine levels, a marker of decreased kidney function [9], the microscopic morphology of transplanted kidney tissue in non adherent patients shows a greater number of histological lesions than in those who adhere closely [10]. As surveys have shown that at least 28% of kidney transplant patients are non adherent to their regimens, non adherence may be a significant contributor to long-term kidney dysfunction [11].One common disadvantage of existing studies exploring the associations between non adherence and clinical outcomes is that they were based predominantly on the older azathioprine-and cyclosporine-based regimens, which are no longer considered state-of-the-art. How far their conclusions can be applied to regimens using subsequent generations of medications, such as tacrolimus, mycophenolate mofetil or sirolimus is an issue that has previously only been investigated in a retrospective study of SummaryLittle is known of the long-term clinical effects of non adherence on transplanted kidneys, especially regarding newer immunosuppressive regimens. In a study of 356 adult Swiss kidney transplant patients, non adherence was measured at inclusion by means of self-reporting, electronic monitoring, collateral reporting and blood assay. Long-term clinical outcomes regarding graft loss and creatinine levels were collected prospectively over a period of 5 years. A Cox proportional hazards model and mixed regression analysis were used, respectively, to examine the effects of non adherence on kidney survival and kidney function. The majority of patients (62%) were on immunosuppressive regimens that included mycophenolate mofetil, tacrolimus or sirolimus. No associations were found between non adherence and kidney graft survival or graft function. Notwithstanding weaknesses of this study, this negative result suggests that high adherence may protect patients against detrimental clinical outcomes, and/or that immunosuppressive regimens containing newer drugs allow wider non adherence margins than those based on previous generation medications such as cyclosporine, azathioprine and corticosteroids.

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Clinical consequences of non adherence to immunosuppressive medication in kidney transplant patients

Denhaerynck

Burkhalter

Schäfer-Keller

et al. 2009

Transplant International

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“…Histological results suggest that the transplanted NSCs mainly differentiate into star-shaped glial cells, and this leads to limb hyperalgesia after transplantation. Because some stem cell transplantations are allogeneic, the long-term use of steroids or immunosuppressive agents is unavoidable and may result in severe adverse reactions and an increased incidence rate of infections and malignancies [26]. Therefore, these complications cannot be ignored when attempting to increase the efficiency of transplantation and differentiation.…”

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Progress in the study of stem cell transplantation for the repair of spinal cord injury

Zhang¹,

Egiazaryan²,

Ратьев³

et al. 2017

Russ Open Med J

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Abstract:Spinal cord injury is a critical medical emergency that severely jeopardizes human health. Such injuries can cause lifelong paralysis and lead to various complications, including death, and there are often tremendous economic and emotional burdens placed on the society and family. Therefore, the study of spinal cord injury repair has important significance. The use of stem cell transplantation to repair spinal cord injury has been the focus and cause of difficulty in studies of spinal cord injury repair in recent years. However, there are numerous types of stem cells, diverse cell transplantation methods and different injury models that often cause confusion for investigators. The goal of this paper is to review the studies of spinal cord injury repair with various stem cells and summarize the bottleneck of stem cell transplantation for spinal cord injury repair to reveal the future direction of stem cell transplantation studies for spinal cord injury repair.

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“…Self-management can be categorized into three broad categories: focusing on illness needs, activating resources and living with a chronic illness [4] or alternatively medical, role and emotion management [3]. For kidney transplant patients, this entails for example adhering to a complex medication regime, managing bodily symptoms, changing lifestyle, regular appointments with health professionals, adapting to changes in social roles and relationships, managing emotions and developing new perspectives on life [5][6][7][8]. In order to perform these self-management tasks, patients require knowledge, skills, beliefs, and a supportive social network (including health professionals) [9].…”

Section: Introductionmentioning

confidence: 99%

Kidney transplant patients’ attitudes towards self-management support: A Q-methodological study

Grijpma

Tielen

Staa

et al. 2016

Patient Education and Counseling

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Posttransplantation Quality of Life: More Than Graft Function

Cited by 55 publications

References 45 publications

Clinical consequences of non adherence to immunosuppressive medication in kidney transplant patients

Clinical consequences of non adherence to immunosuppressive medication in kidney transplant patients

Progress in the study of stem cell transplantation for the repair of spinal cord injury

Kidney transplant patients’ attitudes towards self-management support: A Q-methodological study

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