• 제목/요약/키워드: Liver transplant

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간이식 환자의 뇌경색에 대한 한의학적 치료 증례보고 (Case report of The liver transplant patient's cerebral infarction treated with Korean Medicine)

  • 박상은
    • 대한한의학방제학회지
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    • 제24권3호
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    • pp.225-231
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    • 2016
  • Objectives : Liver cancer usually appears in the setting of underlying liver disease. Liver transplantation has potentials to improve survival for patients with liver cancer. This case report was designed to assess the clinical effect of Korean medicine on liver transplant patient's cerebral infarction.Methods : We provided Chiganpung Granule(Chodeungsan) to a patient who was 58 year old man complained of cognitive impairment and dysarthria. We checked the change of symptoms(K-MMSE, Aphasia Rapid Test) and liver function test and kidney function test.Results : We observed that Chiganpung Granule(Chodeungsan) decreased cognitive impairment and dysarthria. Liver function test and Kidney function test was improved.Conclusions : From the above results, it is considered that Korean medicine treatments is effective on liver transplant patient's cerebral infarction.

Chylomicron Retention Disease: a Description of a New Mutation in a Very Rare Disease

  • Ferreira, Helena;Ramos, Raquel Nunez;Quan, Cinthia Flores;Ferreiro, Susana Redecillas;Ruiz, Vanessa Cabello;Goni, Javi Juamperez;Bernabeu, Jesus Quintero;Canton, Oscar Segarra;Beltran, Marina Alvarez
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권2호
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    • pp.134-140
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    • 2018
  • Chylomicron retention disease, also known as Anderson's disease, is a rare hereditary hypocholesterolemic disorder, recessive inherited, characterized by nonspecific symptoms as abdominal distension, steatorrhea, and vomiting associated with failure to thrive. We describe a patient with failure to thrive, chronic diarrhea and steatorrhea who the diagnosis of chylomicron retention disease was established after several months of disease progression. The genetic study confirmed a homozygosity mutation in SAR1B gene, identifying a mutation never previous described [c.83_84delTG(p.Leu28Argfs*7)]. With this case report the authors aim to highlight for this very rare cause of failure to thrive and for the importance of an attempting diagnosis, in order to start adequate management with low fat diet supplemented with fat-soluble vitamins, reverting the state of malnutrition and avoiding possible irreversible and desvantating complications.

간이식 수혜자의 자기관리 구조모형 (Structural Equation Modeling of Self-Management of Liver Transplant Recipients)

  • 전미경;박연환
    • 대한간호학회지
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    • 제47권5호
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    • pp.663-675
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    • 2017
  • Purpose: The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory. Methods: Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers' autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program. Results: The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers' autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers' autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management. Conclusion: The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.

소아 간이식 (Pediatric Liver Transplantation)

  • 이상훈;이석구
    • Advances in pediatric surgery
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    • 제19권1호
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    • pp.14-21
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    • 2013
  • Pediatric liver transplantation has evolved into a definite and effective therapeutic modality for various liver diseases in the pediatric patient. During the last 25 years, liver transplant outcomes in Korea have reached international standards and Korea has become the leader in living-donor liver transplantation. This review will present the cumulative outcomes of pediatric liver transplantation performed in Korea and will focus on other issues of interest involving pediatric liver transplant recipients, especially in the field of immunosuppression and post-transplant lymphoproliferative disease.

간이식 수혜자의 자가간호이행, 사회적 지지, 생리학적 지표 (Self-care, Social Support, and Biological Markers in Liver Transplant Recipients)

  • 김현경;최모나;김소선;김순일
    • 성인간호학회지
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    • 제27권2호
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    • pp.170-179
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    • 2015
  • Purpose: To examine the relationships between self-care, social support, and biological markers in liver transplant recipients. Methods: The participants included 118 liver transplant recipients who visited outpatient clinic at Y University Hospital in Seoul from April to May, 2013. Questionnaires consisted of self-care and social support scales. The biological markers were collected by reviewing electronic medical records. Data were analyzed with descriptive statistics, t-test, ANOVA with Scheff$\acute{e}$ post-hoc test, and Pearson's correlation. Results: The self-care score was significantly higher in a patient group within 6 months post-transplant when compared to a patient group post-transplant 3 to 5 years (F=3.10, p=.018). The self-care showed positive correlation with social support with statistical significance (r=.36, p<.001). Conclusion: As the self-care in liver transplant recipients had a positive correlation with social support from family and healthcare providers, the development of comprehensive long-term nursing intervention systems including counseling, education, and support in consideration of progress of time period after transplantation is necessary to enhance self-care behaviors among this population.

간이식 수혜자의 적응경험 (Adjustment Experience of Liver Transplant Recipient)

  • 김은만;서문자
    • 재활간호학회지
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    • 제6권1호
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    • pp.61-69
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    • 2003
  • The purpose of this phenomenological study was to understand and describe the essence and the structure of lived experience of liver transplant recipient. Five individual interviews were conducted to gather data regarding their subjective experiences. About 130 significant statements were extracted and these were clusterd into 9 themes. End stage liver disease patients chose their last treatment - liver transplantation. After liver transplantation, recipients experience vague anxiety and uneaseness related to much information and life style change that they had to accept. And they feared to lose their health again. But they felt free from medication and restriction of food. And they satisfied with regaining their physical status. Most of the recipients also had financial difficulties and social restrictions. And they experience uncertainty about their future. But they restored their previous social life. And they experience psychological wellbeing and hope. The results of this study might help nurses who work with liver transplant recipient in establishing and implementing an effective nursing intervention by understanding their lived experience.

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간이식 수혜자의 자기효능감과 이식 관련 지식이 치료지시이행에 미치는 영향 (Effects of Self-efficacy and Transplant-related Knowledge on Compliance with a Therapeutic Regimen for Recipients of Liver Transplant)

  • 문소정;김현주
    • 기본간호학회지
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    • 제26권3호
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    • pp.166-175
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    • 2019
  • Purpose: This study was done to investigate the degree of self-efficacy, transplant-related knowledge, and other factors affecting compliance with a therapeutic regimen for liver transplant recipients. Methods: Participants were 140 patients who had received a liver transplant at a tertiary hospital in Y City, Gyeongnam Province and made regular hospital visits as outpatients. A self-report questionnaire was used to collect the data and collection was done from December 4, 2017 to January 26, 2018. Data were analyzed using frequencies, percentages, means, and standard deviations, and t-test, ANOVA, Pearson's correlation coefficients. Multiple linear regression was performed using SPSS/WIN 21.0 program. Results: Participants scored $113.29{\pm}20.95$ (out of 150) on self-efficacy, $16.38{\pm}3.62$ (out of 18) on transplant-related knowledge, and $148.30{\pm}31.06$ (out of 200) on compliance with the therapeutic regimen. Analyzed of correlations among participant's self-efficacy, transplant-related knowledge, and compliance with the therapeutic regimen showed a significant positive correlation between self-efficacy and compliance with the therapeutic regimen (r=.64, p=.001), but no significant correlations were found between self-efficacy and transplant-related knowledge (r=-.01, p=.912) or between transplant-related knowledge and compliance with the therapeutic regimen (r=.06, p=.458). Multiple regression analysis showed that factors affecting compliance with the therapeutic regimen were state of re-transplantation (${\beta}=.17$, p=.016) and self-efficacy (${\beta}=.53$, p=.001). Conclusion: There is a need to apply a differentiated nursing intervention program considering the differences in patients' self-efficacy, transplant-related knowledge, and compliance with the therapeutic regimen.

간이식 수혜자의 불확실성, 자기효능감 및 사회적 지지와 자가간호 수행 간의 관계 (Relationship between Uncertainty, Self Efficacy, Social Support, and Self-Care Performance in Liver Transplant Recipients)

  • 황가화;이영주
    • 임상간호연구
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    • 제28권2호
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    • pp.89-98
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    • 2022
  • Purpose: This study aimed to determine the correlation between uncertainty, self efficacy, social support, and self-care performance among liver transplant recipients. Methods: Participants comprised 111 liver transplant recipients who visited the outpatient clinic at the hepatobiliary and pancreatic surgery department of a hospital in D city. Data were collected from September to October 2021 using self-report questionnaires, and were analyzed by the SPSS 23.0 program. Results: Self-care performance was correlated with uncertainty (r=-.31, p=.001), self efficacy (r=.22, p=.023), and social support (r=.38, p<.001). Conclusion: To improve self-care performance in liver transplant recipients, it is necessary to develop nursing interventions that can reduce uncertainty and enhance self efficacy and social support.

사체간이식 환자와 생체간이식 환자들의 삶의 질 비교 연구 (Comparing Quality of Life following Liver Transplantation for Cadaveric versus Living Donor Liver Transplant Recipients: A Single-Center Study)

  • 김금희;윤석준;안형식;이준영;박형근;서경석
    • 한국의료질향상학회지
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    • 제11권1호
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    • pp.32-45
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    • 2004
  • Objective : The aim of this study were to measure quality of life(QOL) in liver transplant recipients, to compare QOL between living donor liver transplant recipients and cadaveric liver transplant recipients and to investigate whether SF-36 may be used as a disease-specific instrument in liver transplant recipients. Methods : We conducted a single-center cross-sectional study of 133 LT recipients ages 13 to 65 years, all of whom had had Liver Transplantation(LT) at least 1 months previously. QOL was assessed using a self-completion questionnaire consisting of the Bang Whal Ran(1991) instruments and the 36-Item Short-Form Health Survey(SF-36) health status profile measure. We investigated whether the SF-36 instrument may be used as a disease-specific instrument in LT recipients. Individual scale scores range from 0 to 100, with higher score reflecting better health. Data on demographics, clinical status at pre transplantation 1 day, post transplantation clinical status, and graft function were collected to identify predictors of post transplantation QOL. Results : Standard measures for test-retest reliability, internal consistency, and discriminant and concurrent validity were examined. The reliability of the SF-36, as measured by test-retest correlation(Pearson coefficients: 0.729, p=0.002) and by internal consistency(Cronbach's alpha: 0.9431) exceeded conventional acceptability criteria. The correlation between domain scores of SF-36 and the Bang Whal Ran(l991) was clear and logical in that the clinical characteristics of SF-36 strongly correlated with the clinical component summary score of the Bang Whal Ran(l991)(r = 0.8155, P<.01). SF-36 scale scores were compared between Cadaveric Liver Transplant recipients and Living Donor Liver Transplant recipients. Donor types of post LT did not influence HRQOL(p>0.05). 87% of the liver transplant recipients were satisfied to get LT. Satisfaction of post LT showed significantly greater HRQOL(p<0.001). Conclusion : SF-36 is found reliable and valid. This study indicates thet Donor Type did not influence HRQOL after LT. The information gained from this study will help us to better define expectations and the clinical course after liver transplantation to patients and their families.

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Do changes in inflammatory markers predict hepatocellular carcinoma recurrence and survival after liver transplantation?

  • Lucas Jose Caram;Francisco Calderon;Esteban Masino;Victoria Ardiles;Ezequiel Mauro;Leila Haddad;Juan Pekolj;Jimena Vicens;Adrian Gadano;Eduardo de Santibanes;Martin de Santibanes
    • 한국간담췌외과학회지
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    • 제26권1호
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    • pp.40-46
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    • 2022
  • Backgrounds/Aims: The role of inflammation in malignant cell proliferation has been well described. High values of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation have shown associations with unfavorable long-term outcomes. The purpose of this study was to determine values of NLR and PLR evaluated prior to and after surgery and their associations with mortality and recurrence rates of liver transplant patients with hepatocellular carcinoma (HCC). Methods: A total of 105 patients with HCC who underwent orthotopic liver transplantation (OLT) were retrospectively reviewed. NLR and PLR values were obtained from complete blood counts prior to and after surgery. Overall survival (OS) and recurrence-free survival (RFS) in relation with delta NLR and PLR were estimated. Results: Serum alpha-fetoprotein levels > 100 ng/mL (p = 0.014) and lymphovascular emboli in the specimen (p = 0.048) were identified to be significant predictors of RFS. Child-Pugh score (p = 0.016) was found to be an independent factor associated with poorer OS. An increasing delta PLR was associated with worse RFS, although it showed no significant association with OS. Conclusions: The analysis of PLR as a continuous variable may predict recurrence outcomes in patients undergoing OLT for HCC. It is more representative than isolated values.