• Childhood Kidney Diseases
• /
• v.25 no.1
• /
• pp.8-13
• /
• 2021

Pediatric kidney transplantation is the best option since it can achieve near normal glomerular filtration rate, adequate fluid balance, and autonomic endocrine function of the kidney in end-stage kidney disease. However, pediatric kidney transplantation is difficult because children are developing and growing, management and complications of pediatric kidney transplantation are different from those of adults. This review covers the current status of pediatric kidney transplantation in Korea, key considerations that must be taken before kidney transplantation in children, and management strategy of immunosuppression and common complications.

• Childhood Kidney Diseases
• /
• v.24 no.1
• /
• pp.47-52
• /
• 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.

• Korean Journal of Adult Nursing
• /
• v.21 no.3
• /
• pp.293-302
• /
• 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.

• Korean Journal of Psychosomatic Medicine
• /
• v.6 no.1
• /
• pp.59-69
• /
• 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.

• Journal of Korean Academy of Nursing
• /
• v.28 no.2
• /
• pp.291-302
• /
• 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.

• Korean Journal of Adult Nursing
• /
• v.27 no.1
• /
• pp.11-20
• /
• 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.

• Journal of Veterinary Clinics
• /
• v.18 no.4
• /
• pp.358-362
• /
• 2001

Brain dead (BD) patients remain the largest source of solid organs for transplantation. BD has shown to decrease graft function and survival in rodent models. The aim of this study was to evaluate how brain death affects graft viability in the donor and kidney tolerance to cold preservation as assessed by survival in a canine transplantation. 13 Beagle dogs were used for the study. Brain death was induced by the sudden inflation of a subdural balloon catheter with continuous monitoring of arterial blood pressure and eletroencephalographic activity (n=3). Sixteen hours after conformation of brain death, kidney graft were retrieved (n=6). Non-BD donors served as controls (n=4). All kidneys were flushed with University of Wisconsin (UW) solution and preserved for 24 hours at 4$^{\circ}C$ before transplantation. Recipient survival rates, serum creatinine level were analyzed. Brain death induced the well-known Cushing reaction with a severe increase in blood pressure and tachycardia. Thereafter, cardiac function returned progressively to baseline within 8 hours and remained stable until the end of the experiment. All of dogs in both group transplanted were survived until 7 days (100%), and the kidneys showed functional early rejection at 8.3$\pm$0.5 days and 8.5$\pm$0.5 days after transplantation, in BD and allograft group, respectively. BD kidneys were functionally similar to control kidneys for 7 days after transplantated. Brain death has no deleterious effect on preservation injury and survival of dog kidney transplantation, although it induces changes in hemodynamic parameters. This study reveals that kidneys from BD donors do not exhibit more ischemia reperfusion injury, and support good early function and survival.

• Journal of Yeungnam Medical Science
• /
• v.33 no.2
• /
• pp.150-154
• /
• 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.

• Journal of East-West Nursing Research
• /
• v.18 no.1
• /
• pp.9-17
• /
• 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.

• Journal of Chest Surgery
• /
• v.39 no.9 s.266
• /
• pp.714-717
• /
• 2006

Heart and kidney transplantation has made great progress in the modern era. Coupled with the growing successes in individual solid organ transplantation, there has also been an increase in the number of multiple organ transplants, such as heart-kidney transplantation. This trend has been in part due to a better understanding of immunobiology, advances in surgical technique and postoperative care, and an often-common pathologic association between dual-organ failure. This pathologic course is representative for end-stage heart failure leading to secondary renal dysfunction or failure, or for end-stage renal failure as a cause for (uremic) cardiomyopathy. However, refractory cardiac failure has long been considered a contraindication to kidney transplantation. Additionally, cardiac transplantation has been denied for patients with end-stage renal disease. Over recent years, combined heart-kidney transplantation has been offered to select patients who were once denied transplantation. We report the first experience of combined heart-kidney transplantation with one year follow-up results.