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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Tissue Transplantation01:24

Tissue Transplantation

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
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Living donor liver transplant outcomes during the COVID-19 pandemic: does a decrease in case volume impact the

Shweta A Singh1, Hetal Pampaniya1, Vikram Kumar2

  • 1Department of Anaesthesiology and Critical Care, Center for Liver and Biliary Sciences, Max Super Speciality Hospital, Saket, New Delhi, India.

Korean Journal of Transplantation
|August 3, 2022
PubMed
Summary

Liver transplantation (LT) volumes decreased during the COVID-19 pandemic, but outcomes remained comparable. High-volume centers can maintain non-inferior results even with sicker patients and reduced LT activity.

Keywords:
Health care outcome assessmentHospital bed capacityLiver transplantationSARS-CoV-2

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Area of Science:

  • Hepatology
  • Transplant Surgery
  • Public Health

Background:

  • High-volume centers (HVCs) traditionally correlate with superior patient outcomes.
  • The COVID-19 pandemic significantly reduced liver transplantation (LT) activity at our HVC.
  • This study investigates the impact of decreased LT volume on post-transplant outcomes at an HVC.

Purpose of the Study:

  • To assess the effect of reduced liver transplantation (LT) volume during the COVID-19 pandemic on patient outcomes.
  • To compare the surgical outcomes of LT during the pandemic lockdown with the pre-pandemic period.
  • To evaluate if outcomes at a high-volume center were non-inferior despite a decline in LT procedures.

Main Methods:

  • A comparative study analyzing LT outcomes during the COVID-19 lockdown (April 2020-September 2020) versus the preceding year (April 2019-March 2020).
  • Surgical outcomes were compared between the pandemic and pre-pandemic cohorts.
  • Patient data included Model for End-Stage Liver Disease (MELD) scores, Child-Turcotte-Pugh scores, and mortality rates.

Main Results:

  • LT volume was halved during the pandemic lockdown (60 patients) compared to the pre-pandemic year (228 patients).
  • The pandemic cohort presented with significantly higher MELD and Child-Turcotte-Pugh scores, and a greater incidence of acute-on-chronic liver failure.
  • Despite these challenges, 30-day, 3-month, and 6-month mortality rates were not statistically significantly different between the two groups.

Conclusions:

  • A significant reduction in liver transplantation (LT) procedures occurred at our HVC during the COVID-19 pandemic.
  • Outcomes for LT recipients during the pandemic were non-inferior to those in the pre-pandemic period, despite operating on sicker patients.
  • Individualized patient care strategies likely contributed to maintaining non-inferior outcomes amidst pandemic-related challenges.