• Title/Summary/Keyword: Kidney Transplantation

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Management of Asymptomatic Gallstones in Renal Transplantation

  • Lee, Ru Da;Youn, Seok Hwa;Shin, Dong Hoon
    • Korean Journal of Transplantation
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    • v.28 no.3
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    • pp.160-164
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    • 2014
  • Background: In solid organ transplantation patients, complications of cholelithiasis may run a fulminant course, resulting in high morbidity and mortality under immunosuppression and may even result in rejection. Here, we reviewed medical records of 66 patients in order to determine the outcome of management approach for asymptomatic gallstones in renal transplantation patients. Methods: We retrospectively reviewed clinical courses of 66 cases of renal transplantation performed between 2000 and 2012 at Kosin University Gospel Hospital. Results: Among 66 cases, eight had gallstones before transplantation. Three of these cases had undergone previous cholecystectomy for symptomatic gallstones, one had a simultaneous laparoscopic cholecystectomy and renal transplantation, and four were observed by regular abdominal ultrasonography. One patient was found to have cholangitis, and endoscopic retrograde biliary drainage was performed, resulting in alleviation of symptoms. Among 58 cases without preoperative gallstones, three developed gallstones after transplantation. One patient had cholecystitis, and the symptoms subsided after conservative treatment. Conclusions: For patients with asymptomatic gallstones who are awaiting renal transplantation, expectant management should be considered.

Convergence for adherence: Subjectivity of immunosuppressive medication adherence after kidney transplantation patient (이행증진을 위한 융복합: 신장이식 환자의 면역억제제 투약이행에 대한 주관성)

  • Kim, Min-Young;Lee, Eun-Ju;Park, Euna
    • Journal of Digital Convergence
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    • v.13 no.6
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    • pp.235-246
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    • 2015
  • After kidney transplantation, immunosuppressive medication is essential to enhance the quality of life and survival of the transplanted patient. To promote the medication adherence, subjects are required to have converged attitude with open mind. Medication adherence will depend on the attitude of the psychosocial characteristics and treatment guidelines. The purpose of this study was to identify the specific types and characteristics of medication adherence in the view of kidney transplanted patients. Q-methodology, a technique for extracting subjective opinions, was used. Forty participants completed the Q-sort activity, rating each statement relative to the others. The collected data were analyzed by QUANL PC program. Four types of medication adherence of kidney transplanted patients were identified: 'positive lifestyle management type', 'vigilant appearance management type', 'somber oblivion type', 'vigilant family support type'. Through the identification of attitudes to medication adherence, repeated and individualized medication adherence program will help to prevent graft rejection.

A Case of Hemolysis after Minor ABO Mismatched Kidney Transplantation (ABO 부적합 신이식 후 발생한 용혈 1례)

  • Hahn HyeWon;Ha Il Soo;Cheong Hae Il;Choi Yong
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.120-122
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    • 2002
  • A 9-year-old boy of B blood group with end-stage renal disease due to IgA nephropathy received group O kidney transplantation from his father On day 9, he developed intravascular hemolysis, and anti-B autoantibody formation was confirmed. We diagnosed as immune hemolytic anemia due to passenger lymphocyte from donor, and cyclosporine withdrawl was done. Anemia resolved spontaneously, but on day 18, graft dysfunction developed, and graft biopsy revealed acute allograft rejection. Although hemolysis due to autoantibody is very rare and often mild, and the role of hemoglobinuria on acute rejection in this case is not certain, we recommend consideration of aggressive management on severe hemolysis after minor mismatched kidney transplantation. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 120-2)

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Allograft Immune Reaction of Kidney Transplantation Part 1. Mechanism of Allograft Rejection (신이식 후 면역반응의 이해 - 1부. 이식 거부 반응의 기전 -)

  • Kang, Hee-Gyung
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.23-29
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    • 2008
  • Kidney allograft transplantation is the most effective method of renal replacement for end stage renal disease patients. Still, it is another kind of 'disease', requiring immunosuppression to keep the allograft from rejection(allograft immune reaction). Immune system of the allograft recipient recognizes the graft as a 'pathogen (foreign or danger)', and the allograft-recognizing commanderin-chief of adaptive immune system, T cell, recruits all the components of immune system for attacking the graft. Proper activation and proliferation of T cell require signals from recognizing proper epitope(processed antigen by antigen presenting cell) via T cell receptor, costimulatory stimuli, and cytokines(IL-2). Thus, most of the immunosuppressive agents suppress the process of T cell activation and proliferation.

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Analysis of Unmet needs by Elapsed Time in Kidney Transplantation Patients (신장이식 환자의 수술 후 경과기간에 따른 미충족요구 분석)

  • Noh, Se-Hee;Park, Jeong Sook
    • Journal of the Korea Convergence Society
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    • v.11 no.12
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    • pp.457-467
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    • 2020
  • This study was conducted to for the development of nursing education programs suitable for the period by identifying the unmet needs of kidney transplant surgery patients who need continuous self-care according to the elapsed period. The subjects of the study consisted of 84 inpatients and outpatients for up to 1 year after kidney transplant surgery. The data collection period was from February 17 to May 31, 2020, and the collected data were analyzed by Chi-square, independent t-test, one-way ANOVA, and post-test by Scheffé using the IBM SPSS 21.0 program. As a measurement tool, the Comprehensive Needs Assessment Tool in Cancer(CNAT), a tool to assess unmet needs of cancer patients, was modified and supplemented to receive expert validity, and then self-report through a questionnaire consisting of a total of 57 questions. As a result of the study, the average of the total score out of 171points for the unmet needs of kidney transplant patients was 68.28(±38.88), and information and education accounted for the highest score of 17.92(±8.36) out of the eight sub-areas. The unmet needs according to the elapsed period were significantly higher in the 6 months ~1 year group(F=7.57, p=.001) compared to the 3-6 months group. Based on this, it is necessary to develop a nursing intervention program that can provide appropriate information and support at a time when the unmet needs of patients up to increase from 6 months to one year after kidney transplantation increase.

Kidney Transplantation in End-Stage of Renal Failure with Secondary Hyperparathyroidism (속발성 부갑상선 기능항진증을 동반한 말기 신부전의 치료를 위한 신장이식)

  • Kwak, Ho-Hyun;Nam, Hyun-Suk;Kim, Yun-Tai;Park, In-Chul;Han, Jeong-Hee;Woo, Heung-Myong
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.522-528
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    • 2007
  • A 3-year-old male Maltese dog(weighing 2.5 kg) was referred with an excessive movement of mandible and depression. Comprehensive diagnostic investigation revealed an end-stage of renal disease with secondary hyperparathyroidism. The renal allograft was performed after the condition of dog was stabilized by hemodialysis and medical treatment. After transplantation, the renal function of this dog was returned to normal. thereafter, the dog died suddenly without apparent clinical signs. The subsequent pathological studies revealed the actual etiology of death was not clearly identified However acute pancreatitis caused by abrupt introduction of food after prolonged luting might be involved in the etiology. This case study showed the necessity of pancreatic function test in postoperative management after renal transplantation.

Forensic STR Analysis of Mixed Chimerism after Allogeneic Bone Marrow Transplantation

  • Eom, Yong-Bin
    • Biomedical Science Letters
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    • v.16 no.3
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    • pp.193-196
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    • 2010
  • Multiplex PCR-based short tandem repeat (STR) analysis is considered as a good tool for monitoring bone marrow engraftment after sex-mismatched allogeneic transplantation and provides a sensitive and accurate assessment of the contribution of both donor and/or recipient cells in post-transplantation specimens. Forensic STR analysis and quantitative real time PCR are used to determine the proportion of donor versus recipient each contained within the total DNA. The STR markers were co-amplified in a single reaction by using commercial $PowerPlex^{(R)}$ 16 system and $AmpFISTR^{(R)}$ $Identifiler^{(R)}$ / $Yfiler^{(R)}$ PCR amplification kits. Separation of the PCR products and fluorescence detection were performed by ABI $PRIS^{(R)}$ 3100 Genetic Analyzer with capillary electrophoresis. The $GeneMapper^{TM}$ ID software were used for size calling and analysis of STR profiles. Extracted DNA was quantified by the $Quantifiler^{TM}$ Human DNA / Y Human Male DNA Quantification Kit The intent of this study was to analyze the ratio of donor versus recipient cells in the post-transplant peripheral blood, spleen, lung and kidney specimens. Specimens were taken from the traffic accident male victim who had been engrafted from bone marrow female donor. Blood and spleen specimens displayed female donor DNA profile. Kidney specimen showed male recipient DNA profile. Interestingly, lung tissue showed mixed profiles. The findings of this study indicate that the forensic STR analysis using fluorescence labeling PCR combined with capillary electrophoresis is quick and reliable enough to assess the ratio of donor versus recipient cells and to monitor the mixed chimeric patterns.

BK polyomavirus-associated nephropathy

  • Ahn, Yo Han;Kang, Hee Gyung
    • Childhood Kidney Diseases
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    • v.26 no.1
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    • pp.11-17
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    • 2022
  • BK polyomavirus (BKPyV) is a ubiquitous virus residing in the kidney tubules and is clinically significant only in immunocompromised patients. In clinical practice, BKPyV is a causative pathogen of BKPyV-associated nephropathy (BKVAN) in kidney allograft recipients or hemorrhagic cystitis of hematopoietic stem cell transplant recipients. Currently, there is no effective treatment for BKVAN; therefore, careful monitoring and prudent modification of immunosuppression are necessary to prevent BKVAN. In this article, the epidemiology, pathophysiology, and current management strategies for BKVAN are reviewed.

Long-Term Outcomes of Adult Lung Transplantation Recipients: A Single-Center Experience in South Korea

  • Jo, Kyung-Wook;Hong, Sang-Bum;Kim, Dong Kwan;Jung, Sung Ho;Kim, Hyeong Ryul;Choi, Se Hoon;Lee, Geun Dong;Lee, Sang-Oh;Do, Kyung-Hyun;Chae, Eun Jin;Choi, In-Cheol;Choi, Dae-Kee;Kim, In Ok;Park, Seung-Il;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.348-356
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    • 2019
  • Background: Recently, the number of lung transplants in South Korea has increased. However, the long-term outcome data is limited. In this study, we aimed to investigate the long-term outcomes of adult lung transplantation recipients. Methods: Among the patients that underwent lung transplantation at a tertiary referral center in South Korea between 2008 and 2017, adults patient who underwent deceased-donor lung transplantation with available follow-up data were enrolled. Their medical records were retrospectively reviewed. Results: Through eligibility screening, we identified 60 adult patients that underwent lung (n=51) or heart-lung transplantation (n=9) during the observation period. Idiopathic pulmonary fibrosis (46.7%, 28/60) was the most frequent cause of lung transplantation. For all the 60 patients, the median follow-up duration for post-transplantation was 2.6 years (range, 0.01-7.6). During the post-transplantation follow-up period, 19 patients (31.7%) died at a median duration of 194 days. The survival rates were 75.5%, 67.6%, and 61.8% at 1 year, 3 years, and 5 years, respectively. Out of the 60 patients, 8 (13.3%) were diagnosed with chronic lung allograft dysfunction (CLAD), after a mean duration of $3.3{\pm}2.8years$ post-transplantation. The CLAD development rate was 0%, 17.7%, and 25.8% at 1 year, 3 years, and 5 years, respectively. The most common newly developed post-transplantation comorbidity was the chronic kidney disease (CKD; 54.0%), followed by diabetes mellitus (25.9%). Conclusion: Among the adult lung transplantation recipients at a South Korea tertiary referral center, the long-term survival rates were favorable. The proportion of patients who developed CLAD was not substantial. CKD was the most common post-transplantation comorbidity.

Analysis of Nursing Researches about Organ Donation and Transplantation in Korea (장기기증 및 이식에 관한 국내 간호연구 동향분석)

  • You, Hye-Sook;So, Hyang-Sook;Kim, Hye-Sook
    • Korean Journal of Adult Nursing
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    • v.20 no.6
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    • pp.895-904
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    • 2008
  • Purpose: This study analyzes the trends of nursing researches about organ donation and transplantation, and recommends the direction of future nursing studies in Korea. Methods: Ninety-nine researches based upon organ donation and transplantation in Korea were analyzed by descriptive statistics. Results: Among them 58 papers were master's theses and 9 were doctoral dissertations. Articles about organ beneficiaries were seventy. The 47 articles among them were for kidney transplantation. By the types of research design, there were 73 quantitative studies, 19 qualitative studies, and 9 methodological studies. In correlation studies, the quality of life of subjects were evaluated the association with stress, social support, self-efficacy, and compliance. In experimental studies, the independent variables were self efficacy promotion exercise, steroid medication, educational programs regarding an organ transplantation and a brain death, DanJeon breathing exercise, and telephone counseling. The methods of qualitative studies were based on the grounded theory, phenomenology, interpretive phenomenology, and ethnography. The dominant concepts of qualitative researches were experiences of a decision-making of donors and of recipients for organ transplantation. Conclusion: Descriptive surveys or correlation studies were predominant on the nursing research about organ transplantation. Qualitative studies were conducted to some extent. It is recommended to conduct clinically applicable interventional researches with the experimental design.

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