Clinical transplantation
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Clinical transplantation · Sep 2007
Quality of life and psychological well-being during and after left ventricular assist device support.
Left ventricular assist devices (LVAD) are increasingly being used to treat patients in end-stage heart failure to facilitate survival to cardiac transplant or as a bridge to myocardial recovery. The technical innovation of the LVAD has a significant benefit on the patients' physical functioning. However, within the United Kingdom, there has been no systematic evaluation of the psychological adjustment and quality of life (QoL) of patients currently living with an LVAD, or of the differences in QoL for patients who are either explanted or transplanted. ⋯ For patients with an LVAD in situ, there was a trend for QoL and psychological functioning to be poorer than for transplanted and explanted patients. Larger studies will be needed to confirm these findings, but psychological assessment and interventions to reduce psychological morbidity and improve QoL will be important in these patients, particularly in view of the increasing numbers of LVADs being implanted and the possibility of their use for long-term "destination" therapy.
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Clinical transplantation · Sep 2007
Influence of cytokine genes polymorphisms on long-term outcome in renal transplantation.
Recently, polymorphisms of cytokine genes have been associated with modified gene expression and increased cytokine production. We evaluated the influence of interleukin-10 (IL-10) gene G-1082A, tumour necrosis factor alpha (TNFalpha) gene G-308A and IL-6 gene G-174C polymorphisms on the rejection rate, renal function and long-term outcome in renal transplantation. ⋯ Our results suggest that IL-10 gene G-1082A, TNFalpha gene G-308A and IL-6 gene G-174C polymorphisms are no major risk factors in renal transplantation.
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Clinical transplantation · May 2007
Using thyroid hormone in brain-dead donors to maximize the number of organs available for transplantation.
The aggressive management of brain-dead (cadaveric) organ donors has been shown to increase organs available for transplantation. Some centers use hormone therapy with thyroid hormone (T(4)) in selected donors. The purpose of this study is to evaluate the effects of T(4) on organs available for transplantation. ⋯ Compared with donors who did not receive T(4), those that did were similar in age (32 +/- 14 vs. 38 +/- 21, p = 0.148), had more organs donated (3.9 +/- 1.7 vs. 3.2 +/- 1.7, p = 0.048), and had no differences in brain-death related complications. Despite the severe hemodynamic instability in the T(4) group, the number of organs harvested from this group was significantly more than in patients who did not receive T(4). The use of T(4) in this group may result in the increased salvage of transplantable organs.
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Clinical transplantation · Nov 2006
Are personnel in transplant hospitals in favor of cadaveric organ donation? Multivariate attitudinal study in a hospital with a solid organ transplant program.
A considerable number of professionals who work in a hospital could be against organ donation, which means that when the time comes, they could act as an obstacle to donation. The objective of this study was to analyze the attitude of hospital professionals toward organ donation and to determine the factors that influence this attitude in a Spanish center with a transplant program. ⋯ Attitude toward cadaveric organ donation among personnel in a transplant hospital is similar to that described in the general public and is determined by many factors. The following factors are most noteworthy: (i) job category; (ii) knowledge of the concept of brain death; (iii) consideration of the matter of donation in the family; and (iv) fear of manipulation of the cadaver. In view of this attitude, which is similar to that of the general public, it is necessary to carry out promotion activities if we want to increase cadaveric donation rates.
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Clinical transplantation · Nov 2006
Intraoperative hypotension and prolonged operative time as risk factors for slow graft function in kidney transplant recipients.
Slow graft function (SGF) is an immediate post-operative complication of cadaveric kidney transplantation pre-disposing to acute rejection (AR) and lower graft survival. The objective of this study was to test whether intraoperative hypotension and/or prolonged operative time are risk factors for SGF in patients post-cadaveric kidney transplant. ⋯ Intraoperative hypotension and prolonged operative time are independent risk factors for SGF in patients post-cadaveric kidney transplant.