The Difficulties and Needs of Organ Transplant Recipients during Postoperative Care at Home: A Systematic Review

Abstract

With recent advances in surgery and immunosuppressive drugs, organ transplantation has become a major treatment for irreversible organ failure. However, organ transplant recipients returning home after operation may face ongoing physiological, psychological, and social difficulties. To increase recipients’ quality of life, postoperative care at home is critical. Thus, the aim of this systematic literature review was to explore recipients’ difficulties and needs during postoperative care at home. Our search conformed to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and returned 23 relevant articles published from 1997–2020 in PubMed, MEDLINE, EBSCO, Cochrane, ProQuest, and CEPS, which were assessed using the Modified Jadad Scale or the 32 Consolidated Criteria for Reporting Qualitative Research (COREQ) appraisal indices and then synthesized through narration. The most common difficulties faced were psychological difficulties, followed by physiological, social, and other difficulties; the most common needs were psychological needs, followed by education and information training, social, and other needs. These results demonstrated that healthcare professionals can do more to provide patients with comprehensive care and promote successful self-management and quality of life at home. They also confirmed that collaboration between transplant teams, caregivers, and patients is necessary to optimize postoperative outcomes. We suggest that customized care may promote postoperative patients’ self-management and quality of life at home.

Unmet Care Needs and Related Factors of Lung Transplant Patients at Home

“…If lung transplant patients suffer from anxiety for a long time, it will threaten their sense of security and even lead to physical and mental diseases (Wang et al, 2014). In addition, transplant patients seek social support from loved ones, friends, and other patients to adjust to their new lifestyle and social roles (Yang et al, 2020). By assisting patients with social interactions with family and friends and giving them some encouragement and support, we can both improve their coping skills and accelerate their postoperative recovery, which in turn will improve their quality of life (Kaba & Shanley, 1997).…”

Lingering Identity as Chronically Ill and the Unanticipated Effects of Life-Changing Precision Medicine in Cystic Fibrosis: A Case Report

“…Perhaps the transplant care model could serve as an example in which patients are screened before and after their life-changing, life-saving surgeries to assess for any potential challenges in post-transplant adjustment. A recent systematic review describes the difficulties and needs of organ transplant recipients, specifically related to psychological concerns (10).…”

Self-management in adults after solid-organ transplantation: a scoping review protocol

“…Contrarily, SOTx recipients need to implement fundamental lifestyle changes and be adherent to a complex medical regimen in order to prevent graft rejection, infections and secondary complications 8–10. Furthermore, recipients face various psychological, physiological and social difficulties and challenges after SOTx such as fear and anxiety concerning graft loss, fatigue and distressing medication side effects, or social isolation due to infection prevention 11. Lifelong medical follow-up in cooperation with healthcare providers and self-management of recipients is required to manage and cope with the situation post transplantation and to maintain health and quality of life 9 10 12…”

“…Previous research suggests that some SOTx recipients struggle with the implementation of necessary self-management tasks and lifestyle changes11 17–22 and therefore need self-management support 11 17 23–25. Literature review findings suggest that the majority of self-management support interventions mainly focus on treatment and medication adherence after SOTx 26–32.…”

“…However, there is evidence to suggest self-management needs extend beyond adherence and medical therapy. Research revealed psychological (emotional and spiritual), relational and social support needs 11 24. A potential explanation for this is the fact that self-management after transplantation is only partially conceptualised and thus lacks a theoretical basis for further supportive interventions.…”