Validation of the Adapted Social Assessment Instrument for Liver Transplantation Candidates.

BACKGROUND AND AIMS: Assessment is considered a duty, as well as a part of the tasks of social workers; in addition, they have an ethical commitment to improve their working tools. This study aimed at validating the Adapted Social Assessment Instrument used in a transplant center in the state of São Paulo, Brazil, for liver transplantation candidates, requiring its improvement and strengthening. METHODS: The methodology was based on both Marxian dialectics and the method of content validation. The content validation analysis was performed by 5 social workers from 3 Brazilian transplant centers. They evaluated the 5 domains of the instrument: identification, socio-demographic profile, eligibility criteria, evaluation, and social interventions. Descriptive statistics of data were performed, and qualitative analysis was associated to the participant observation. RESULTS: The 5 professionals (100%) assigned the scores 3 and 4, which have demonstrated clarity, relevance, and feasibility, pointing out suggestions for improvement, some of which were considered. CONCLUSIONS: The instrument was evaluated with an approval percentage of above 80%; therefore, the instrument is a valid measure.

Effectiveness Analysis of the Immunization Against Hepatitis B in Liver Transplantation Patients.

OBJECTIVE: This article analyzes the effectiveness of a super-accelerated immunization schedule against hepatitis B in patients who have received a liver transplantation. METHODS: This is a quantitative and retrospective study based on secondary data of medical records from 177 patients who have received a liver transplantation at the Hospital de Base in São José do Rio Preto, São Paulo State, Brazil, between 1998 and 2016. RESULTS: From the total number of participants, 72.89% were male, 39.55% had a cirrhosis diagnosis with associated causes, 23.16% had hepatocellular carcinoma, 53.11% were classified according to Child-Turcotte-Pugh C score, 58.76% had the hepatitis C virus, 97.18% had received an unconventional immunization schedule, and seroconversion was 36.63% among those with an unconventional schedule. The fact that the patient had the hepatitis C virus was statistically significant considering the lack of protection of the vaccine against the hepatitis B virus; their chances were 5 times higher of not seroconverting at the end of the immunization schedule. CONCLUSION: The need for high immediate protection in a short term may justify using unconventional immunization schedules in patients who make it to the transplantation waiting list without any previous immunization.