• Journal of Korean Biological Nursing Science
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• 제22권1호
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• pp.23-35
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• 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.

• 대한간호학회지
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• 제39권4호
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• pp.518-527
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• 2009

Purpose: The purpose of this study was to identify factors influencing quality of life in kidney transplant recipients and to understand the concrete pathway of influence and the power of each variable, so that integrated prediction model to promote the quality of life of kidney transplant recipients could be developed. Methods: The sample was composed of 218 patients in follow-up care after a kidney transplant in one of 4 university hospitals in the Honam area. A structured questionnaire was used and the collected data were analyzed for fitness, using the LISREL program. Results: This model was concise and extensive in predicting the quality of life of kidney transplant recipients. Conclusion: The research verified the factors influencing quality of life for kidney transplant recipients and it verified that direct factors such as perception of health state, compliance, self-efficacy, stress and indirect factors such as self-efficacy and social support can be important factors to predict the quality of life for recipients. Moreover, those variables represent 87% of variance in explaining quality of life in a prediction model so that the variables can be utilized to predict quality of life for kidney transplant recipients.

• 대한간호학회지
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• 제29권4호
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• pp.790-801
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• 1999

The purpose of this study was to generate a grounded theory of how families with kidney donor or recipient coped with kidney transplantations. Interview data from twelve families involved in kidney transplants was analyzed using the grounded theory method. Data analysis revealed that “protecting the family” was the main theme that represented family member experiences. In order to maintain family function and to protect the family from breaking up, family members had to adjust the family structure from the traditional style of a husband-centered family, to one that was patient health -centered. The process of this adjustment was a very long and difficult one, taking several years from the recognition of the kidney disease to the kidney transplants. Family members, especially spouses, employed nine different strategies to deal with various problems and conflicts which occurred during the process : 1) paying attention to the patient's illness and complications ; 2) accepting the patient's illness as the family's illness as well ; 3) managing the patient's illness and complications that occured ; 4) being thrifty ; 5)supporting the kidney donor ; 6) accepting and replacing the lost roles of the patient ; 7) keeping composure and encouraging the patient ; 8) sustaining the patient's independence ; 9) self-restraining sexual desires. These findings suggest that there is a developmental process where family members adjust to a kidney transplant over time. There is also a need for increased social and psychological health services for all family members over the course of kidney transplants.

• Journal of Yeungnam Medical Science
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• 제33권2호
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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.

• 대한이식학회지
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• 제28권3호
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• pp.121-134
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• 2014

Current immunosuppressants have nonspecific immuosuppressive effects, and are not helpful for tolerance induction. Consequently, transplant patients cannot discontinue using them, and their nonspecific immunosuppressive effects result in many side effects, including infection and malignancy. However, most of cellular immunotherapy can have donor antigen-specific immunsuppressive effects. Therefore, cell therapy could be an alternative or adjunctive to nonspecific immunosuppressants. Polyclonal or antigen-specific Foxp3+ regulatory T cells have been actively tried for prevention of acute rejection, treatment of chronic rejection, or tolerance induction in clinical trials. Regulatory macrophages are also under clinical trials for kidney transplant patients. IL-10-secreting type 1 regulatory T cells and donor- or recipient-derived tolerogenic dendritic cells will also be used for immunoregulation in clinical trials of kidney transplantation. These cells have antigen-specific immunoregulatory effects. Mesenchymal stromal cells (MSCs) have good proliferative capacity and immunosuppressive actions independently of major histocompatibility complex; therefore, even third-party MSCs can be stored and used for many patients. Cell therapy using various immunoregulatory cells is now promising for not only reducing side effects of nonspecific immunosuppressants but also induction of immune tolerance, and is expected to contribute to better outcomes in transplant patients.

• Childhood Kidney Diseases
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• 제12권2호
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• pp.133-142
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• 2008

이식을 위해서는 수여자와 공여자의 혈액형과 HLA type을 알아야 한다. 통상 ABO 혈액형이 적합한 경우 이식할 수 있으며 HLA 부적합은 근래 큰 문제가 되지 않으나 HLA 부적합이 없는 경우 이식장기의 장기생존률이 높다. PRA(panel reactive antibody)는 수여자가 HLA에 감작되었는지 검사하는 방법이며 이식 전에는 반드시 교차반응 검사를 하여 음성인 경우에만 이식을 진행한다. 이식 전후에 donor specific antibody(DSA)를 검사하여 이식장기에 대한 수여자의 면역반응을 예측 할 수 있다. 근래에는 스테로이드, calcineurin inhibitor(cyclosporine, tacrolimus), azathioprine 또는 mycophenolate mofetil (MMF)의 삼제요법을 주로 사용하며 항림프구 항체 (Thymoglobulin 또는 항IL-2 receptor 항체 basiliximab/daclizumab)을 이용하여 이식 초기에 면역억제상태를 induction하는 경우도 많다.

• 대한의생명과학회지
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• 제16권3호
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• pp.193-196
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• 2010

Multiplex PCR-based short tandem repeat (STR) analysis is considered as a good tool for monitoring bone marrow engraftment after sex-mismatched allogeneic transplantation and provides a sensitive and accurate assessment of the contribution of both donor and/or recipient cells in post-transplantation specimens. Forensic STR analysis and quantitative real time PCR are used to determine the proportion of donor versus recipient each contained within the total DNA. The STR markers were co-amplified in a single reaction by using commercial $PowerPlex^{(R)}$ 16 system and $AmpFISTR^{(R)}$ $Identifiler^{(R)}$ / $Yfiler^{(R)}$ PCR amplification kits. Separation of the PCR products and fluorescence detection were performed by ABI $PRIS^{(R)}$ 3100 Genetic Analyzer with capillary electrophoresis. The $GeneMapper^{TM}$ ID software were used for size calling and analysis of STR profiles. Extracted DNA was quantified by the $Quantifiler^{TM}$ Human DNA / Y Human Male DNA Quantification Kit The intent of this study was to analyze the ratio of donor versus recipient cells in the post-transplant peripheral blood, spleen, lung and kidney specimens. Specimens were taken from the traffic accident male victim who had been engrafted from bone marrow female donor. Blood and spleen specimens displayed female donor DNA profile. Kidney specimen showed male recipient DNA profile. Interestingly, lung tissue showed mixed profiles. The findings of this study indicate that the forensic STR analysis using fluorescence labeling PCR combined with capillary electrophoresis is quick and reliable enough to assess the ratio of donor versus recipient cells and to monitor the mixed chimeric patterns.

• 성인간호학회지
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• 제21권3호
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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.

• 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.

• Genomics & Informatics
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• 제15권1호
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• pp.2-10
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• 2017

Early detection and proper management of kidney rejection are crucial for the long-term health of a transplant recipient. Recipients are normally monitored by serum creatinine measurement and sometimes with graft biopsies. Donor-derived cell-free deoxyribonucleic acid (cfDNA) in the recipient's plasma and/or urine may be a better indicator of acute rejection. We evaluated digital PCR (dPCR) as a system for monitoring graft status using single nucleotide polymorphism (SNP)-based detection of donor DNA in plasma or urine. We compared the detection abilities of the QX200, RainDrop, and QuantStudio 3D dPCR systems. The QX200 was the most accurate and sensitive. Plasma and/or urine samples were isolated from 34 kidney recipients at multiple time points after transplantation, and analyzed by dPCR using the QX200. We found that donor DNA was almost undetectable in plasma DNA samples, whereas a high percentage of donor DNA was measured in urine DNA samples, indicating that urine is a good source of cfDNA for patient monitoring. We found that at least 24% of the highly polymorphic SNPs used to identify individuals could also identify donor cfDNA in transplant patient samples. Our results further showed that autosomal, sex-specific, and mitochondrial SNPs were suitable markers for identifying donor cfDNA. Finally, we found that donor-derived cfDNA measurement by dPCR was not sufficient to predict a patient's clinical condition. Our results indicate that donor-derived cfDNA is not an accurate predictor of kidney status in kidney transplant patients.