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.

Response to Immunosuppressive Therapy and an HLA-DR Allele in Children with Aplastic Anemia / 대한혈액학회지

BACKGROUND: Genetic susceptibility to a variety of disease has been shown and it has recently been suggested that aplastic anemia is more common in adults who are HLA-DR2+ than in the general population. METHODS: To investigate whether certain HLA-DR gene is more common in children with aplastic anemia and HLA-DR2+ gene is associated with susceptibility to cyclosporine A (CyA), we analyzed the results of HLA-DR typing in 37 children with aplastic anemia with sequence specific oligonucleotide probe (SSOP) method. RESULTS: Eight patients were DR2+, and there was no more common than the normal population. All of the 8 patients with DR2+ were DRB1*1501+ with high resolution HLA typing. Of the 8 patients with DRB1*1501+, 3 patients were treated with CyA alone (2 patients) or CyA plus ATG (1 patient), 2 patients were treated with ATG (1 patient) or ALG alone (1 patient). Patients treated with CyA only or CyA plus ATG had either a complete (1 patient) or partial (2 patients) response and patients treated ATG or ALG alone had no response. CONCLUSION: Although incidence of HLA-DR2 was not significantly higher in children with aplastic anemia then normal population, response rate to CyA was significantly high in the DR2+ patients.