• Title/Summary/Keyword: Organ 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.

Hematopoietic stem cell transplantation : overview for general pediatrician (조혈모세포이식)

  • Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.613-621
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    • 2007
  • Hematopoietic stem cell transplantation (HSCT) has expanded and evolved substantially in the last decades to treat various malignant and nonmalignant diseases. However, the conditioning regimen can lead to transplantation related death by major organ dysfunction, severe infection and bleeding. In the allogeneic setting, graft versus host disease may also develop, making post-transplant management complex. To overcome these problems, new stem cell sources, stem cell mobilizing agents and new skills, nonmyeloablative stem cell transplantation including reduced intensity stem cell transplantation has been introduced in clinical practice, but problems remained so far. Recipients of stem cell transplant may be severely immunocompromised for many months after transplantation. Furthermore, long-term complications (endocrine, metabolic, relapse, second malignancies, etc) can develop. Pediatrician is open called on to participate in the evaluation and consideration of patients for possible transplant and long-term follow-up of HSCT patients. This review is intended as a basic overview of HSCT relevant to general pediatrician.

Factors Affecting Attitudes toward Brain Death Organ Donation among Nurses and Doctors in an Operating Room (수술실 의료진의 뇌사자 장기기증 태도 관련 요인)

  • Cho, Eunjeong;Shin, Gisoo
    • Journal of East-West Nursing Research
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    • v.28 no.1
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    • pp.49-56
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    • 2022
  • Purpose: This study was conducted to identify the factors affecting the attitudes toward brain death organ donation among nurses and doctors in an operating room. Methods: A descriptive research was used. The participants included 90 nurses and 30 doctors who had experience of operating organ transplantation for brain death organ donation. Data were collected from March 12 to May 23, 2020 in the one tertiary general hospital. The outcome measures were perception and attitude of death and attitude towards brain death organ donation. Results: Attitudes toward brain death organ donation was influenced by type of occupation, intention of organ donation and attitude toward death. In addition, the explanatory power of the total variance was 52.1%. Conclusions: Based on the results, it is necessary to prepare an intervention to improve awareness of the brain death and the brain death organ donation.

Pediatric heart transplantation: how to manage problems affecting long-term outcomes?

  • Kim, Young Hwue
    • Clinical and Experimental Pediatrics
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    • v.64 no.2
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    • pp.49-59
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    • 2021
  • Since the initial International Society of Heart Lung Transplantation registry was published in 1982, the number of pediatric heart transplantations has increased markedly, reaching a steady state of 500-550 transplantation annually and occupying up to 10% of total heart transplantations. Heart transplantation is considered an established therapeutic option for patients with end-stage heart disease. The long-term outcomes of pediatric heart transplantations were comparable to those of adults. Issues affecting long-term outcomes include acute cellular rejection, antibody-mediated rejection, cardiac allograft vasculopathy, infection, prolonged renal dysfunction, and malignancies such as posttransplant lymphoproliferative disorder. This article focuses on medical issues before pediatric heart transplantation, according to the Korean Network of Organ Sharing registry and as well as major problems such as graft rejection and cardiac allograft vasculopathy. To reduce graft failure rate and improve long-term outcomes, meticulous monitoring for rejection and medication compliance are also important, especially in adolescents.

A Bioethical Study of the Informed Consent for Organ Donor (장기공여를 위한 사전동의의 생의윤리학적 고찰)

  • Um, Young-Rhan;Han, Sung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.475-487
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    • 1998
  • This is a study to search for the ethical basis for valid informed consent of organ donors. It is an admirable action that a person give his own body part or organ as a gift to another person. The organ for transplantation can be removed only when the donor consents voluntarily to donation. It is recently proposed as the need for organ transplantation is increased that organs can be harvested although the consent of deceased cannot be obtained. This may raise many moral issues because human beings all have an unalienable right to control their own bodies. The principle of autonomy is usually regarded as an ethical basis for informed consent. However, some people criticize that the principle of autonomy requires a person and his decision to be autonomous (but there are many patients who aren't autonomous due to their confusion or unconscious condition in a clinical situation). or this principle can foster indifference to patients needing help: thus respect for principles of care and beneficence is necessary. When we consider the complexity of making a decision about organ donation. the principle of autonomy should be replaced by the principle of respect for individual autonomy. as expressed by Childress (1990). This principle requires the care givers to respect the client's individual decisions. The elements of informed consent are threshold elements: competence to understand and decide. voluntariness in deciding: information elements: disclosure of material information. recommendation of a plan. understanding of disclosure and recommendation: and consent elements: decision in favor of a plan. authorization of the chosen plan. In cases of living donors. the elements of competence and voluntariness are more important than the others. So only an adult can give a recipient his own body part. but it should be forbidden to harvest from minors or protected adults (i.e. developmentally disabled person However. when organs are removed from a cadaver donor. we ought to respect the donor's decision. So we ought to try to seek donor cards or any documents expressing the donor's opinion about organ transplant. All health care givers ought to disclose donor information about organ transplantation clearly enough for the donor to understand it and to be able to weigh the harms and benefits. We are going to propose 'the subjective standard' as the ethical standard of disclosure. This standard will assure that patients have enough information to be able to decide autonomously from their own position. Care givers have to consider the method of disclosure because donors can be influenced by it positively or negatively, Establishment of the Hospital Committee is recommended. because medical professionals will have a chance to discuss the procedure of decision and the validity of harvesting a organ from a person.

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Establishment of optimal decellularization conditions using porcine placenta

  • Son, Ji Hyung;Kim, Dae-Jung;Lee, Dong-Mok;Seo, Byoung Boo
    • Journal of Animal Reproduction and Biotechnology
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    • v.36 no.4
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    • pp.253-260
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    • 2021
  • Organ transplantation is currently the most fundamental treatment for organ failure, but there is a shortage of organ supply compared to those in need. Regenerative medicine has recently developed a decellularization technique that overcomes the limitations of conventional organ transplantation and attempts to reconstruct damaged tissues or organs to their normal state. Several decellularization methods have been suggested. In this experiment, the decellularization methods were used to find effective decellularization methods for humanlike porcine placenta. The optimal conditions for decellular support are low DNA content and high glycos amino glycans (GAGs) and collagen content. In order to satisfy this condition, SDS and Triton X-100 and SDS + Triton X-100 were used as the detergent used for decellularization in this experiment. The contents were compared according to the decellularization time (0, 12, 24, 48 and 72 hours), and the concentrations of SDS (0.2, 0.5, 0.7 and 1.0%) were mixed in 1.0% Triton X-100 to analyze the contents. When decellularized using SDS and Triton X-100, respectively, it was confirmed that the contents of DNA and GAGs were opposite to each other. And decellularization treatment for 24 hours at 0.5% SDS was able to obtain an effective decellular support. If decellularization studies of various detergents can be obtained an effective decellular support, and furthermore, cell culture experiments can confirm the effect on the cells.

Mental Health Issues in Solid-Organ Transplant Recipients; Pre-, Peri-, and Post-Transplant Phases (고형장기이식 환자의 정신건강: 이식의 시기별 이슈)

  • Yeonjin Jung;Jee In Kang
    • Anxiety and mood
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    • v.19 no.2
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    • pp.37-47
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    • 2023
  • This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

The Effect of Brain Death Organ Donation Education on Nurses' Knowledge and Attitude (뇌사 장기기증 교육이 간호사의 뇌사 장기기증에 대한 지식과 태도에 미치는 효과)

  • You, Hye Sook
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.57-65
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    • 2009
  • Purpose: This study was conducted to examine the effects of Brain Death Organ Donation Education on nurses' knowledge and attitudes. Methods: It is a quasi-experimental study using the non-equivalent control group. A total of 100 nurses participated in the study; 50 in the experimental group, and the rest in control group. Collected data were analyzed using ${\chi}^2-test$, t-test and ANCOVA by SPSS 12.0 program Results: There was a statistically significant difference in knowledge (F=13.29, p<.001), and attitude (F=4.35, p=.040) after the experimental group received Brain Death Organ Donation Education. Conclusion: The Brain Death Organ Donation Education was revealed as an effective tool in improving nurses' knowledge and attitudes toward organ donation.