• Title, Summary, Keyword: kidney transplantation

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Pneumocystis Pneumonia after Kidney Transplantation in Children

  • Hwang, Soojin;Jung, Jiwon;Lee, Joo Hoon;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.24 no.1
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    • pp.47-52
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    • 2020
  • Pneumocystis pneumonia (PCP) is a rare disease in healthy people but a potentially fatal opportunistic infection by Pneumocystis jirovecii in immunocompromised patients with organ transplantation. We present three cases of PCP after kidney transplantation in pediatric patients. First case was a 4-year-old boy diagnosed with Denys-Drash syndrome and received living-donor kidney transplantation from his mother at age of 1. Second case was a 19-year-old male, with polycystic kidney disease, who received kidney transplantation from his mother at the age of 18. Third case was a 19-year-old female with chronic kidney disease of unknown etiology, who received kidney transplantation from her father at age of 15. These three patients who were on immunosuppressive therapy and completed of routine PCP prophylaxis for 6 months had presented with cough and dyspnea more than 1 year after transplantation. Chest x-ray all showed diffuse haziness of both lung fields, and bronchoalveolar lavage from bronchoscopy revealed Pneumocystisjirovecii infection. All patients showed clinical resolution with intravenous trimethoprim-sulfamethoxazole (TMP-SMX) therapy for at least 3 weeks and had continued secondary prophylaxis for another 6-12 months. This report suggests that clinicians should have suspicion for the possibilities of opportunistic infection such as PCP after kidney transplantation in children.

En bloc transplantation of horseshoe kidney in Korea

  • Bang, Jun Bae;Lee, Jae Myeong;Oh, Chang-Kwon;Lee, Kyo Won;Park, Jae Berm;Kim, Sung Joo;Lee, Su Hyung
    • Annals of Surgical Treatment and Research
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    • v.92 no.3
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    • pp.168-172
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    • 2017
  • Transplantation of the horseshoe kidney can be performed en bloc or split into 2 grafts according to the vascular anomaly and the existence of the urinary collecting system in isthmus. From 2011 to 2014, there were 3 horseshoe kidney transplantations in Korea and transplantations were performed at 2 different centers. The transplantations were carried out successfully for all recipients without complications. All recipients have shown good graft kidney function after transplantation. No severe complication was revealed during follow-up period. We described the surgical technique used in the en bloc method to overcome various vascular anomalies and difficulties in choosing cannulation site and postoperative complications. En bloc transplantation of a horseshoe kidney is a useful strategy for patients with end-stage renal disease, and can provide favorable outcomes compared to the transplantation of a normal kidney.

Experiences of renal transplants from donors with renal cell carcinoma after ex vivo partial nephrectomy

  • Lim, Sung Yoon;Kim, Myung Gyu;Park, Kwon Tae;Jung, Cheol Woong
    • Annals of Surgical Treatment and Research
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    • v.92 no.5
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    • pp.361-364
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    • 2017
  • Purpose: Routine evaluation of kidney donors occasionally reveals an incidental renal mass with an otherwise satisfactory kidney function. The use of such a kidney with an enhancing mass for transplantation is a matter of debate owing to a possible risk of transmission of donor malignancies. We report our experience of kidney transplants from donors with renal cell carcinoma, after ex vivo resection of the renal mass. Methods: Two women aged 44 and 56 years were diagnosed with enhancing renal masses measuring 0.9 cm and 0.7 cm, respectively, during donor evaluation for kidney transplantation. Both patients and their families were informed of a potential risk of recurrent renal cell carcinoma following transplantation. Results: Renal function test results of both donors satisfied the living donor selection criteria. Laparoscopic live donor nephrectomy was performed with ex vivo resection of renal masses on the bench table. Immediate pathological analysis revealed a renal cell carcinoma with a margin of normal renal parenchyma before transplantation. Regimens based on mammalian target of rapamycin inhibitors, which are known for their antitumoral properties, were used for immunosuppression in both recipients. None of the recipients showed recurrence or metastasis during the follow-up period, which was longer than 3 years after transplantation. Conclusion: In light of the ongoing shortage of kidney donors, kidneys with small renal cell carcinoma could be considered for transplantation after appropriate removal of the lesion, with a very low risk of recurrent disease.

The Effectiveness of Perceived Stress and Social Support on the Quality of Life for Kidney Transplantation Recipients (신장이식환자의 지각된 스트레스와 사회적 지지가 삶의 질에 미치는 영향)

  • Kim, Hye-Sook
    • Korean Journal of Adult Nursing
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    • v.21 no.3
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    • pp.293-302
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    • 2009
  • Purpose: This study is descriptive study that confirms the affect of the factors of perceived stress and social support of the kidney transplantation recipient affect on the quality of life. Mothods: 167 subjects who have received kidney transplantation in a university hospital in G city. Data obtained are analyzed by SPSS Win 13.0. Results: The perceived stress based on transplantation related characteristics and general traits of kidney transplantation has significant differences only in frequency of admission. The subjects who had been supported by acquittances have more significant social support index. The quality of life has significant differences in number of admissions, gender and occupation. Also, when the perceived stress of kidney transplantation recipients is lower and social support is higher, the quality of life is higher. The perceived stress has 28.1% increment of quality of life. Adding social support, both of them affect 34.8% increment of quality of life. Conclusion: To decrease the factor to cause the stress of kidney transplantation recipients, it is necessary to have social support networks and to develop plans and programs to increase the quality of life of recipients.

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Psychiatric Comparison Study of Kidney Transplantation Patient and Hemodialysis Patients (신투석 환자와 신장 이식 환자의 정신의학적 비교 연구)

  • Cho, Dong-Hwan;Park, Bum-Yong;Kong, Jin-Min;Kim, Jeong-Gee
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.59-69
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    • 1998
  • Objectives: This research was performed to know severity of depression and anxiety, the psychopathology of hemodialysis patients and kidney transplantation patients using Minneesota Multiphasic Personality Inventory(MMPI) and Zung's Self-rating Depression Scale (SDS), Zung's Self-rating Anxiety Scale(SAS), MMPI Subscales. Methods: We surveyed 31 hemodialysis patients and 119 kidney transplantation patients. 119 kidney transplantation group(KT) was investigated at ; 1) Before kidney transplantation (KT-1), 2) Three days after kidney transplantation(KT-2), 3) Three weeks after kidney transplantation(KT-3),4) Follow up at OPD(F/U). Results: 1) According to dermographic data, mean age was KT 33.1, HD 42.2, Control 33.1 years old and KT, HD were belonged to lower economic states and lower educational level than Control. 2) In the depression scale for SDS, KT-1 was more depressed than F/U and Control but depression scale was significantly decreased at KT-2 in comparison with HD. In the anxiety scale for SAS, KT-1 was more anxious than Control but anxiety scale was not different within IT subgroups and in comparison with HD. 3) In comparison of MMPI scales, Hs, D, Pt, Ma at KT-1, Pd, Pa, Pt, Ma at KT-2, F, D, Pd, Pt, Pa, Sc, Ma at KT-3, Pt at F/U were more high scores than Control.

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Psychosocial Adjustment after Kidney Transplantation (신장이식술 후의 사회심리적 적응)

  • 이명선
    • Journal of Korean Academy of Nursing
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    • v.28 no.2
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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.

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A Study on Self-efficacy, Coping, and Compliance in Patients with Kidney Transplantation (신장 이식 환자의 자기효능감, 대처 행동, 치료지시 이행에 관한 연구)

  • Lee, Jeong Lan;Park, Hyojung
    • Korean Journal of Adult Nursing
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    • v.27 no.1
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    • pp.11-20
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    • 2015
  • Purpose: The purpose was to examine the self-efficacy, coping, and compliance in patients with kidney transplantation. Methods: Participants consisted of 300 outpatients who underwent kidney transplantation and regularly visited hospital for health check-up. A tool developed by Ahn (2000) was used for measuring self-efficacy. A modified version of the Jalowiec Coping Scale (Jalowiec, 1987) by Hwang (2004) was used for measuring coping, and a tool developed by Ryu, Kim, and Kang (2003) was used for compliance. Data were analyzed using SPSS program version 21.0 ANOVA, Pearson's correlation coefficient, and Scheff$\acute{e}$'s test for post-hoc test. Results: Coping shows significant differences according to marital status and education. Coping was used more often among patients with ABO incompatible transplantation than those with ABO compatible. Differences in compliance were significant according to donor type, ABO incompatible, period after transplantation, and admission after the transplantation. The management of life style, stress, nutrition, and exercise in self-efficacy and compliance had lower scores than the others. Conclusion: There are significant correlations between self-efficacy, coping, and compliance in patients with kidney transplant which might be helpful for health care professionals in taking care of these population.

Chronic hepatitis C healed by peginterferon-α and rivabirin treatment after kidney transplantation (만성 C형 간염의 신이식 환자에서 페그인터페론 알파와 리바비린 병합치료로 치유한 1예)

  • Seok, Min Gue;Lee, Tae Hee;Yun, Sung Ro;Hwang, Won Min;Yoon, Se Hee;Choe, In Soo;Kang, Seong Joo;Hong, Ju Young;Kim, Dae Sung
    • Yeungnam University Journal of Medicine
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    • v.33 no.2
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    • pp.150-154
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    • 2016
  • Hepatitis C virus (HCV) infection is present in a high proportion of patients with kidney transplantation. Compared with uninfected kidney transplant recipients, HCV infected kidney recipient have higher prevalence of liver disease and worse allograft survival after transplantation. Interferon monotherapy before transplantation is standard therapy for HCV-infected kidney transplant candidates. If HCV infection is discovered after transplantation, interferon monotherapy is considered due to the limited critical situation. However, in this patient, who was a kidney recipient, HCV infection was treated after kidney transplantation with peginterferon-${\alpha}$ and rivabirin. As a result, the patient achieved sustained virologic response.

The Effects of an Individual Educational Program on Self-care Knowledge and Self-care Behavior in Kidney Transplantation Patients (신장이식환자에 대한 개별교육프로그램이 자가간호 지식과 자가간호수행에 미치는 영향)

  • Sim, Mi-Kyung;Son, Sun-Young
    • Journal of East-West Nursing Research
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    • v.18 no.1
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    • pp.9-17
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    • 2012
  • Purpose: The purpose of this study was to identify the effects of an individual educational program on self-care knowledge and self-care behavior in kidney transplantation patients. Methods: The kidney transplantation patients were recruited from a transplantation center, at a university hospital located in Korea. Data were collected from June 1, 2010 to January 31, 2011. The research design was a nonequivalent one group pre-post test. Forty-two subjects were participated two times individually in an educational program given by the researcher. Results: After the intervention, the participants showed a significant increase in self-care knowledge(t=-4.10, p=.000) and self-care behavior (t=-6.07, p=.000) than before the intervention. Conclusion: This results suggest that the program developed in this study can be considered an effective nursing intervention for health promotion, prevention of complication and self-care behavior in kidney transplantation patients.