The Symptom Experience Associated with Immunosuppressive Therapy in Organ Transplant Recipients / 대한이식학회지

PURPOSE: The purpose of this study was to investigate symptom frequency and symptom discomfort in liver, kidney and heart transplant recipients. METHODS: This descriptive, comparative study included 191 subjects (86 liver, 81 kidney, 24 heart: 135 male, 56 female). The symptom frequency and distress questionnaires were used to examine the symptom experience of the subjects. RESULTS: The most frequent and distressing symptom was fatigue. Increased hair, increased appetite, poor concentration and poor vision were frequently reported and poor vision, poor concentration, muscle weakness, and headache were causing high distress. Women reported a significantly higher level of symptom frequency and discomfort than men. Heart recipients reported a significantly higher level of symptom frequency and discomfort than renal or liver recipients. Significant (P<0.05) differences were found in symptom frequency and discomfort depending on transplant organs, numbers of immunosuppressants genders, age and types of drug and time after transplantation. Most of symptoms were related to the side effects of cyclosporine or corticosteroids. CONCLUSION: The results provide a basis for patient and family education and for symptom management. Further investigation of the symptom experience of the transplant patients is needed, especially in relation to quality of life.

The Change of Muscle Strength, Muscle Endurance, Flexibility and Activities of Daily Living of the Kidney Transplant Recipients / 성인간호학회지

The purpose of this study was to explore the change of muscle strength, muscle endurance, flexibility and activities of daily living to develop a rehabilitational program. The subjects were selected randomly among the patients who underwent kidney transplantations at one major transplantation hospital in Seoul, Korea. This study was carried out between November 23, 1999 and February 15, 2000. The subjects in this study consisted of 16 patients who had kidney transplantations between 1 month and 12 months ago prior to this study. They were all on steroids and did not take any physical exercise regularly. The muscle strength, muscle endurance, flexibility and activities of daily living were evaluated at 1st week and after 12 weeks. The data were analyzed with numbers, percentiles, mean, standard deviation and t-test. The results were as follows: 1. After 12 weeks, the grip strength was significantly decreased than 1st week (p=.0002). 2. After 12 weeks, the back lift strength was significantly decreased than 1st week (p=.0002). 3. After 12 weeks, the muscle endurance was increased than 1st week, but it was not significant(p=.5487). After 12 weeks, the flexibility was significantly decreased than 1st week (p=.0002). 5. After 12 weeks, the activities of daily living was significantly decreased than 1st week (p=.0006). Like the above result, the kidney transplant receipients' muscle strength, flexibility and activities of daily living were reduced. In order to solve this problem, the writer has found that program development to prevent the defects should be extremely required. Since now on the number of patients should expand. After the kidney transplantation, the periods of 4, 8, 12 and 16 weeks are extended. The writer proposes to examine the different phase of change in each periods.

Study on Physician's Perceptions and Attitudes on Organ Donation in Brain Dead Donors / 대한이식학회지

PURPOSE: The demand for suitable organs in the world greatly outweighs the supply of transplantable organs. Perceptions and attitudes of the attending physician to brain death are pivotal for the organ donation process in brain dead donors. The purpose of this study is to evaluate the perceptions and attitudes of the attending physician on brain death and organ donation in order to promote the organ donation from brain dead donors in Korea. METHODS: Questionnaires were collected from 194 (17.9%) among 1,018 physicians and were analyzed by descriptive statistics. RESULTS: 97.5% (189/194) of respondents have positive attitudes toward organ donation. Although 97.9% (190/194) have experienced donor management, the referral rate was no more than half (96/194, 49.5%). The main barriers against organ donation were lack of knowledge on organ donation and transplantation (60/129, 46.5%), cultural background (27/120, 20.9%) and complexity in the organ donation process (12/129, 9.3%). CONCLUSION: Promotion of organ procurement organization and well trained-education programs are crucial to help attending physicians to understand the organ donation process, and eventually to increase the rate of organ donations in brain dead donors.

Potential Organ Donor Pool for Renal Transplantation in Intensive Care Unit and Emergency Room : Single center study for donor action program / 대한이식학회지

Organ shortage remains a main obstacle to the development of organ transplantation for end stage organ disease. Identification of potential donors is a key point of donation/transplantation process. We evaluated the entire potential organ donor developed in intensive care unit and emergency room to find out the way to improve the real donation program .Pro-and retrospective analysis were performed in death patient occurred in intensive care unit and emergency room between May. 1997 and Oct. 1997. There are 394 death patients in ICU and 324 in ER during study period. 293 patients (74.3%) were eliminated by age under 1 year or over 70 years, and medical disease unsuitable for organ transplantation. After a series of elimination due to no possibility of brain death or organ unsutability, 35 patients (8.9%) finally were found to be a acceptable potential donors for organ transplantation in ICU, and 3 (0.9%) in ER. 28 of the 35 potential donors (80.0%) were found in neurology or neurosurgery ICU. Causes of brain death in 35 potential donors were traumatic intracerebral injury in 10 (29.4%), and non traumatic intracranial cerebral catastrophe in 21 (61.8%). Actual multiorgan harvest was performed in 2 (5.7%) among 35 medically acceptable potential donors in ICU. Three (8.6%) among 35 potential donors refused organ donation by donor families, 29 (82.9%) could not be actual donors due to absence of any information on organ donation to families of donors. Conclusively organ donation rate and efficacy from the potential donor are very poor in this series. Comprehensive donor action programs including practical donor detection program with donor linker, education program to medical staff and public are mandatory to increase the cadaveric organ donation effectively.