• 기본간호학회지
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• 제2권2호
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• pp.139-154
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• 1995

The purpose of this study was presented basic data for management of living kidney donor to make bioethical decision. The research subjects were the documents and progress notes of Doctor's and Nurses in medical records related to kidney donation and nephrectomy of 20 kidney donors who received nephretomy at 4 general hospitals in Pusan. The result of this study, a desirable documents to help the living kidney donor might include following : 1st, identification of the donor and the guardian. 2nd, confirmation of the intension of kidney donor which is based on humanity or not and 3rd, a written oath about Nephrectomy. Especially it is more desirable to participate of paramedical personnels such as the religious, the social workers, the counsellors, and etc when assess the motivation of kidney donor and to use of a formulated visual educational materials about renal angiography and nephrectomy which required written consent of kidney donor. Further more, the donor should be educated sufficiently about the kidney itself and procedure for nephrectomy-the anatomical position of kidney, the function of the kidney, the operative maneaver, pre and post operative complication, the prevention of the complication, the possiblity of rejection phenomenon and loss of the transplanted kidney etc. In conclusion, medical team members for kidney transplantation must suggest not only physical problem but also psychological problem And the educated donor ought to have enough time before a making decision and all these process should be recorded in medical records

• 보험의학회지
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• 제29권2호
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• pp.18-21
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• 2010

Background: The kidney transplantation is increasing. The kidney donation of a living donor is more common in Korea than in other countries. Underwriters may encounter a case of a kidney donor. So we need to determine medical risk for a living kidney donor. Methods: Comparative mortality figures were calculated from a source article using mortality analysis methods. Results: Mortality Ratio of a living kidney donor was estimated to 106%, and Excess Death Rate was 0.89 per 1000. Discussion: A healthy kidney donor is quite within standard, even better in terms of medical risk.

• 정신신체의학
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• 제31권2호
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• pp.43-49
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• 2023

우리나라의 경우, 이식 대기자에 비해 공여 장기 수가 부족하여 생체 장기기증에 대한 의존도가 높으며, 생체 장기기증 건수도 지속적으로 증가하고 있다. 특히, 생체 신장 이식 건수는 전 세계적으로 높기 때문에 생체 신장 공여자에 대한 이식 전 정신사회적 평가의 중요성이 부각되고 있다. 이전 연구에 따르면 이식 전 공여자 평가 시 사전 동의 여부 및 수술 위험성에 대한 인지 여부를 파악하는 것이 중요하며 이를 위해 다음과 같은 평가 도구들을 시행할 수 있다. ELPAT living organ donor Psychological Assessment Tool (EPAT), Live Donor Assessment Tool (LDAT), Living Donation Expectancies Questionnaire (LDEQ), Minnesota Multiphasic Personality Inventory-2 questionnaire (MMPI-2). 이식 전 정신사회적 평가 도구에 관한 문헌을 검토한 후, 한국의 생체 신장 기증자에 대한 법적 고려 사항을 살펴본 후 생체 신장 공여자에 대한 효과적인 이식 전 선별 평가 방법을 제안하려 한다.

• 대한간호학회지
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• 제30권1호
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• pp.47-59
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• 2000

The purpose of this study was to explore decision making phenomenon of living kidney donation experienced by kidney donors. Data were collected through semi-structured indepth interviews from 12 kidney donors. All interviewes were audiotaped and transcribed verbatim. Constant comparative analysis was used to analyze the data with NUDIST4.0 software program. process have effects on the execution of kidney donation. Based on the degree of "wish to give", three distinct patterns were identified: Voluntary, compromising, and passive. The voluntary decision making was the most frequent one, while the passive the least. The degree of "wish to give" was influenced by intimacy between the donor and the receipient, geographical locations, economical efficiency of kidney transplantation, and religion. Each pattern was explained by describing interfering and facilitating factors as well as other issues occured in the decision making process. The results of this study will help nurses make effective nursing intervention by understanding the characteristics of decision-making patterns and decision-making process to donate a living kidney.

• 대한간호학회지
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• 제28권2호
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• pp.291-302
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• 1998

The purpose of this phenomenological study was to understand and describe the essence and the structure of lived experience of people with kidney transplantation. Initially, nine individual interviews were conducted to gather data regarding their subjective experiences. And two focus group interviews were utilized to validate or discard the themes that were emerged from the analysis using Colaizzi's method. Among 17 participants, 13 had living related kidney donations, one living unrelated, and the remaining two cadavor donations. About 130 significant statements were extracted and these were clustered into 11 themes. All participants felt anxiety and fear toward the rejection of transplantation and the complication of immunosuppressive drugs. Although they were initially satisfied with their life after kidney transplantation, most of them lost a self-confidence and experienced loneliness, depression, and despair. Most of the participants also felt guilty for not being able to accomplish their appropriate roles in the family, They also had financial difficulties and social restrictions. However, they overcame these psychosocial distress by exercising, working and sharing love with others. They also could overcome it by living a religious life and by working to help others with kidney transplantations. Most of them felt gratitude toward the donor and did not have a psychological rejection toward the kidney transplanted. The results of the study might help nurses who work with people with kidney transplantations in establishing and implementing an effective nursing intervention by understanding their lived experience.

• 대한간호학회지
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• 제25권2호
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• pp.222-243
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• 1995

The purpose of this study was to present basic data in the nursing practice for the management of living kidney donor by understanding the nature and meaning of kidney donors, experiences. The research subjects were 11 living kidney donors who had donated from Mar 1991 to Feb. 1994 and discharged from the 3 hospitals in Pusan. Data has been collected by Intensive interview with donors. The data analysis has made by phenomenological method of Van Kaam for understanding the phenomenon and meaning of their experiences. The experiences of kidney donors were analyzed into the 4 situations, that is,'motivation of kidney donor', 'decision time to make kidney donation', 'pre-opperation','after donation'. The descriptive expression and common elements were drawn from original data of each situation on the basis of subjects' own words. From each situation, the com-mon elements of kidney donors' experiences were integrated, summarized and described as follows 1. Motivation of kidney donation They wanted to donate their kidney because of empathy of pain on the groung of love to the recipient and with exppectation of successful kidney transplant or as a solution of economic difficulty. 2. Experiences in deciding to make kidney do-nation In deciding to make kidney donation, donors had love toward the recipients. But they experienced conflict too. 3. Experiences before being operated on donated kidney In experiences from deciding to make kidney do nation to preoperation, donors had love toward the recipients. But they also felt anxiety or dissatisfaction. Therefore, they controlled their mind by their faith, support of medical staff or support of society. And they experienced regret for the sociological cognition or financial apprehension. 4. Experiences after kidney donation After kidney donation, donors experienced satis-faction and accompplishment in spite of mental and physical discomfortness, while they felt sense of loss / disappointment, repentance, regret, and apprehension of progress toward their condition. Thus, kidney donors donated their kidney on the ground of empathy and love to the recipient and with expectation of successful kidney transplant. But during the process of kidney donation, they ex perienced conflict, love, anxiety, regret, apprehension of economy. And after donation, they felt sense of satisfaction and accomplishment, while they felt sense of discomfortness, loss / disappointment, re-gret, repentance, or apprehension of progress toward their condition. This result contribute to nurses' role not only for the management of living kidney donors but also for the management of cadaver donors' family.

• 대한이식학회지
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• 제28권3호
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• pp.144-153
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• 2014

Background: Normal renal function and health have been recognized as important factors in living donors after kidney donation. The purpose of this study was to evaluate the health status and health-promoting lifestyle in living donors after kidney donation. Methods: A total of 678 living-kidney donors were counted in our center from January 1990 to December 2011. Only 84 donors agreed to participate in the survey by telephone. We received consent for participation in our survey from 48 donors (57.1%). Data were collected from May to August 2013 using donor characteristics, health status, and Health Promoting Lifestyle Profile I (HPLP-I). Results: The donors were predominantly female (62.5%) and the average age was 48.9±11.8 years, and the average period after nephrectomy was 9.7±5.7 years. The characteristics of donors included ideal body weight (37.5%), overweight (37.5%) in body mass index, and good health status (81.3%). Most donors underwent an annual medical check-up (56.2%), no health problem (81.3%), and no disease (64.6%). However, one patient was treated with dialysis for renal failure due to diabetes. The total average score for HPLP-I was 128.3±13.9. Higher than average scores (116.3±19.1) were observed for the general middle-aged woman. There were statistically significant differences in self-realization and nutrition in subsection of HPLP-I. Self-realization showed a higher score for Christian (F=2.743, P=0.041) and good health (F=3.389, P=0.017). Nutrition showed a higher score for overweight, obesity (F=6.783, P=0.000), and older than 60 (F=3.854, P=0.009). Conclusions: Most living kidney donors were healthy after their donation and had relatively high scores for health-promoting lifestyle. However, one patient had a serious health problem. In addition, younger, longer period after donation, and the rare health examination of donors showed a lower health-promoting lifestyle. Designed and continuous health-care management after transplantation is needed for kidney donors.

• 임상간호연구
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• 제19권3호
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• pp.395-406
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• 2013

Purpose: This study was aimed to investigate the relationship between the level of stress and the quality of life among the adult recipients of living donor liver transplantation. Methods: Participants were 213 outpatients who received living donor liver transplantation at least 3 months prior to this study. Stress was measured using a modified version of the Kidney Transplant Recipient Stressor Scale (KTRSS), and the quality of life was measured using SF-36 version 2. Results: The mean of scaled stress level and quality of life of liver transplant recipients were $2.44{\pm}0.13$, $69.28{\pm}18.25$, respectively. There was an inverse correlation between those two parameters. Therefore lower stress could improve quality of life. Conclusion: For the liver transplantation recipients, improving the quality of life is to be the ultimate goal of health-related mediation. Liver transplantation recipients would need to cultivate self-care ability to manage stress, and improving their quality of life.

• Journal of International Society for Simulation Surgery
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• 제1권1호
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• pp.37-40
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• 2014

Purpose For living donor liver transplantation, liver segmentation is difficult due to the variability of its shape across patients and similarity of the density of neighbor organs such as heart, stomach, kidney, and spleen. In this paper, we propose an automatic segmentation of the liver using multi-planar anatomy and deformable surface model in portal phase of abdominal contrast-enhanced CT images. Method Our method is composed of four main steps. First, the optimal liver volume is extracted by positional information of pelvis and rib and by separating lungs and heart from CT images. Second, anisotropic diffusing filtering and adaptive thresholding are used to segment the initial liver volume. Third, morphological opening and connected component labeling are applied to multiple planes for removing neighbor organs. Finally, deformable surface model and probability summation map are performed to refine a posterior liver surface and missing left robe in previous step. Results All experimental datasets were acquired on ten living donors using a SIEMENS CT system. Each image had a matrix size of $512{\times}512$ pixels with in-plane resolutions ranging from 0.54 to 0.70 mm. The slice spacing was 2.0 mm and the number of images per scan ranged from 136 to 229. For accuracy evaluation, the average symmetric surface distance (ASD) and the volume overlap error (VE) between automatic segmentation and manual segmentation by two radiologists are calculated. The ASD was $0.26{\pm}0.12mm$ for manual1 versus automatic and $0.24{\pm}0.09mm$ for manual2 versus automatic while that of inter-radiologists was $0.23{\pm}0.05mm$. The VE was $0.86{\pm}0.45%$ for manual1 versus automatic and $0.73{\pm}0.33%$ for manaual2 versus automatic while that of inter-radiologist was $0.76{\pm}0.21%$. Conclusion Our method can be used for the liver volumetry for the pre-surgery planning of living donor liver transplantation.

• 대한이식학회지
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• 제31권4호
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• pp.200-206
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• 2017

Background: Risk factors for bone avascular necrosis (AVN), a common late complication after kidney transplantation (KT), are not well known. Methods: Patients that underwent living-donor KT at Asan Medical Center between January 2009 and July 2016 were included in this retrospective study to determine the incidence and risk factors for AVN after KT. Results: Among 1,570 patients that underwent living-donor KT, 33 (2.1%) developed AVN during a mean follow-up of 49.8±25.0 months. Additionally, AVN was diagnosed at a mean of 13.9±6.6 months after KT. The mean cumulative corticosteroid dose during the last follow-up in patients without AVN (9,108±3,400 mg) was higher than that that in patients with AVN (4,483±1,114 mg) until AVN development (P<0.01). More patients among those with AVN (n=4, 12.1%) underwent steroid pulse treatment because of biopsy-proven rejections during the first 6 months after KT than patients without AVN (n=68, 4.4%; P=0.04). Female (hazard ratio [HR], 2.29; P=0.04) and steroid pulse treatment during the first 6 months (HR, 2.31; P=0.02) were significant AVN risk factors as revealed by the Cox proportional multivariate analysis. However, no significant differences in rejection-free graft survival rates were observed between the two groups (P=0.67). Conclusions: Steroid pulse treatment within 6 months of KT and being female were independent risk factors for AVN development.