• Journal of Korean Academy of Nursing
• /
• v.54 no.1
• /
• pp.93-105
• /
• 2024

Purpose: The study aimed to understand the semantic structure and nature of the disease experience of kidney transplant recipients with kidney graft failure by applying phenomenological research methods. Methods: Data were collected between February and September 2021 through individual in-depth interviews with 12 kidney transplant recipients with kidney graft failure. Colaizzi's phenomenological analysis was used to analyze the meaning of the participants' illness experiences. Results: 5 theme clusters and 15 themes were derived. The five theme clusters are as follows: (1) First transplant giving me a second life; (2) Body and mind becoming sick again; (3) Waiting for a re-transplant with hope and worry; (4) Life supported by gratefulness; (5) Having control over my own life. Conclusion: This study shows that kidney transplant recipients with kidney graft failure experience physical and psychological difficulties during the long disease period and require help from many people, including family members, friends, colleagues, and health care providers, to overcome their difficulties.

• Journal of Chest Surgery
• /
• v.40 no.7 s.276
• /
• pp.467-472
• /
• 2007

Background: Lung transplantation is the definitive therapy for end stage lung disorders. The success of allogenic lung transplantation has led to an increasing shortage of donor lungs from humans, including cadavers, and attention has now turned to transplantation of lungs from other species. However, there are many biological hurdles when using organs from other species because of hyperacute rejection after discordant xenotransplantation. Material and Method: Pigs (n=6, weighing $20{\sim}30kg$ each) for the donors and mongrel dogs (n=6, weighing $20{\sim}28kg$ each) for the recipients were used in this experiment. The left kidney of a pig was perfused to a mongrel dog for 30 minutes through the femoral artery and vein of the dog, and the right kidney was perfused for 30 minutes sequentially. Then, both lungs of the pig were perfused to the dog through the pulmonary artery and left atrium with using the same time intervals. The levels of IgM and IgG were measured from the blood and specimens of the kidney and lung. Result: The average levels of serum IgM gradually decreased after the perfusion, but the average levels of serum IgG did not charge from before to after perfusion. The immunohistochemical findings revealed decreased deposition of IgG and IgM after the perfusion. Conclusion: We conclude that the levels of the serum natural antibodies would be decreased with pre-transplantation xenograft perfusion in the recipient and the occurrence rate of hyperacute rejection after transplantation would be decreased.

• Korean Journal of Adult Nursing
• /
• v.18 no.1
• /
• pp.136-145
• /
• 2006

Purpose: This study was performed to identify relationships among stress, hardiness, and the level of self-care in kidney transplant patients and use the results of this study as baseline data for developing self-care promotion programs. Method: Subjects were 41 patients who undergone a kidney transplantation surgery at least one month before and were receiving regular follow-up care via OPD. Four researchers interviewed each subjects by filling out questionnaires. Results: The mean score of the level of stress was 2.32(SD=0.54) on a 4 point scale and the mean score of hardiness was 4.68(SD=0.62) on a 6 point scale. The mean score of self-care among the subjects was 3.83(SD=0.55). There was statistically a significant positive relationship between selfcare and hardiness(r=0.42). Especially, relationships between self-care and commitment (r=.51) and control(r=.36) as the subdimensions of hardiness were significant. The item suggested as most stressful was economic burden and the item suggested as least stressful was sexual activity. Conclusion: Although transplant patients have various stressors, the positive self-care activities of the patients could be increased if the commitment and control were enhanced by proper intervention programs.

• Journal of Korean Biological Nursing Science
• /
• v.17 no.4
• /
• pp.331-340
• /
• 2015

Purpose: This study was to develop and evaluate an individualized education program based on self-efficacy for patients with kidney transplantation in Korea. Methods: A nonequivalent control group pretest-posttest design was used. The participants consisted of 43 patients who underwent kidney transplants at one hospital in Seoul, from July 2012 to April 2013. The experimental group received an individualized education based on self-efficacy in the hospital and follow-up telephone consultation in the 2nd and 3rd week after discharge. The control group received a routine discharge education. Knowledge, self-efficacy, and compliance related to kidney transplant were measured and analyzed by frequency, average, Mann-Whitney U test, Fisher's exact test, independent t-test, and ${\chi}^2$-test using SPSS WIN 20.0. Results: Significant differences were found in self-efficacy between the experimental group and the control group. But no significant differences were found in knowledge and compliance between two groups. The scores of several items on monitoring health status in compliance were higher in the experimental group than those of the control group. Conclusion: The results of this study demonstrate the fact that an education program based in self-efficacy for patients with kidney transplant would be effective in improving self-efficacy and the ability to monitor their health status.

• Journal of Korean Biological Nursing Science
• /
• v.22 no.1
• /
• pp.23-35
• /
• 2020

Purpose: Compliance in kidney transplant recipients is critical for a positive prognosis. Especially compliance with medications after kidney transplantation is a major health care issue with implications for graft rejection and graft loss. But the definition of compliance in transplantation varies among centers. The purpose of this study was to clarify the concept of compliance in kidney transplant recipients. Methods: A literature search was conducted using RISS, MEDLINE, CINAHL. The concept analysis was guided by the methodology posited by Walker and Avant. Results: In this study, we found the attributes of the concept: 'compliance with immunosuppressive medication', 'compliance with follow-up', 'compliance with early detection of graft rejection and complication', and 'compliance with prevention of complication'. The antecedents of 'compliance in kidney transplant recipients' included 'having a kidney transplant surgery' and 'normal function of transplanted kidney'. The consequences of 'compliance in kidney transplant recipients' included 'affecting the function of the transplanted kidney' and 'affecting the health of kidney transplant recipients. Conclusion: This study may contribute to the development of tools for measuring compliance in kidney transplant recipients, as well as benefit nursing interventions research to increase compliance in kidney transplant recipients.

• Journal of Korean Critical Care Nursing
• /
• v.4 no.2
• /
• pp.15-25
• /
• 2011

Purpose: The purpose of this study was to identify compliance of kidney transplantation(=KT) recipients and the factors influencing on compliance of KT recipients. Methods: One hundred patients who visited out-patients department after KT at S hospital transplant center in Seoul were enrolled in this study. Structured questionnaires of compliance, self-efficacy and family support were used to collect data. The data was collected from April 21 to May 21 in 2011. The data were analyzed by descriptive statistics, independent t-test, ANOVA and Pearson correlation coefficient. Statistical significance was accepted to the level of p<.05. Results: The mean score of compliance was 4.37(range from 1 to 5), and that of medication compliance was the highest and that of self care compliance was the lowest. There were no differences of compliance according to characteristics of the subjects. Compliance of the subjects had positive correlation with self-efficacy(r=0.23, p<0.05) and family support(r=0.33, p<0.05). Conclusion: Based on these results, it can be concluded that the nursing intervention program to improve self care using self-efficacy and family support need to be developed.

• Childhood Kidney Diseases
• /
• v.18 no.1
• /
• pp.51-55
• /
• 2014

Primary renal artery aneurysm has been estimated to account for an incidence of 0.015-1% with associated morbidities including renovascular hypertension and rupture. Renovascular hypertension associated renal artery aneurysms in children is not a common disease. In patients with complicated renal vascular disease, renal autotransplantation has been used as an alternative to percutaneous transluminal angioplasty, which may be hazardous in these situations. We report a case of a renal artery aneurysm in a 13-year-old Korean child presenting hypertension detected during school health examination. Preoperative workup demonstrated a $2.8{\times}2.1{\times}1.9$ cm saccular aneurysm in the right renal hilum that was not amendable to endovascular repair. A surgical strategy including extracorporeal renal artery reconstruction with autotransplantation was applied in order to restore renal artery anatomy and to treat renovascular hypertension. Immediately he complained of severe right flank pain and postoperative doppler sonography revealed lack of perfusion. On the 5th day after autotransplantation, the patient underwent a transplant nephrectomy. He was well postoperatively and was found to have a normal kidney function and stable blood pressure control without antihypertensive medication. This is the first pediatric case of renal artery aneurysm in Korea who underwent extracorporeal repair followed by autotransplantation failure. More pediatric cases with renal artery aneurysm should be reported to identify therapeutic outcome and long term prognosis.

• Clinical and Experimental Pediatrics
• /
• v.53 no.3
• /
• pp.420-427
• /
• 2010

Purpose : Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods : One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid function, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction. Results : Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were $0.08{\pm}1.04$, $-0.09{\pm}1.02$, and $-0.27{\pm}1.18$, respectively (P =0.001). Height SDS significantly decreased in patients who received total body irradiation (TBI) (P =0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P =0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P =0.001). Conclusion : The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.29 no.3
• /
• pp.186-190
• /
• 2003

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.

• Journal of radiological science and technology
• /
• v.39 no.2
• /
• pp.199-208
• /
• 2016

$^{99}mTc-MAG_3$ Renal scan is a method that acquires dynamic renal scan image by using $^{99}mTc-MAG_3$ and dynamically visualizes process of radioactive agent being absorbed to kidney and excreted continuously. Once the test starts, ratio in both kidneys in 1~2.5 minutes was measured to obtain split renal function and split renal function can be expressed in ratio based on overall renal function. This study is based on compares split renal function obtained from data acquired from posterior detector, which is a conventional renal function test method, with split renal function acquired from the geometric mean of values obtained from anterior and posterior detectors, and studies utility of attenuation compensation depending on difference in geometric mean kidney depth. From July, 2015 to February 2016, 33 patients who undertook $^{99}mTc-MAG_3$ Renal scan(13 male, 20 female, average age of 44.66 with range of 5~70, average height of 160.40cm, average weight of 55.40kg) were selected as subjects. Depth of kidney was shown to be 65.82 mm at average for left and 71.62 mm at average for right. In supine position, 30 out of 33 patients showed higher ratio of deep-situated kidney and lower ratio of shallow-situated kidney. Such result is deemed to be due to correction by attenuation between deep-situated kidney and detector and in case where there is difference between the depth of both kidneys such as, lesions in or around kidney, spine malformation, and ectopic kidney, ratio of deep-situated kidney must be compensated for more accurate calculation of split renal function, when compared to the conventional test method (posterior detector counting).