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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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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
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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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Bone Marrow Sampling and Transplants01:22

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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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Identifying Modifiable System-Level Barriers to Living Donor Kidney Transplantation.

Shaifali Sandal1,2, Ian Schiller2,3, Nandini Dendukuri2,3

  • 1Division of Nephrology, Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.

Kidney International Reports
|December 19, 2022
PubMed
Summary

System-level barriers hinder living donor kidney transplantation (LDKT). Improving communication, role clarity, and resources in lower-performing regions can significantly boost LDKT rates.

Keywords:
barriershealth professionalshealth systemliving donor kidney transplantation

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Area of Science:

  • Health Services Research
  • Transplantation Science
  • Public Health Policy

Background:

  • Living donor kidney transplantation (LDKT) performance varies significantly across health systems.
  • Identifying and addressing system-level barriers is crucial for improving LDKT rates.
  • Previous research has highlighted several potential barriers to LDKT.

Purpose of the Study:

  • To quantify previously identified barriers to LDKT.
  • To estimate the association between these barriers and LDKT performance.
  • To inform comprehensive, system-level strategies for enhancing LDKT.

Main Methods:

  • A cross-sectional survey was administered to 353 health professionals (HPs).
  • Statements assessed themes including communication, role perception, HP education/training/comfort, attitudes, referral processes, patient factors, and resources/infrastructure.
  • Responses were analyzed and compared based on LDKT performance (above/below national average) and participant characteristics.

Main Results:

  • Poor communication, role perception, and HP training/comfort were identified as key barriers.
  • HPs in low-performing provinces reported lower agreement on provincial promotion of LDKT (aOR=0.27) and initiating LDKT discussions (aOR=0.30).
  • HPs in low-performing provinces were more likely to believe the transplant team should discuss LDKT (aOR=2.64) and that more resources are needed (aOR=2.06).

Conclusions:

  • System-level barriers significantly impact LDKT, with some barriers more prevalent in lower-performing regions.
  • Interventions targeting these barriers should be integrated with patient-level strategies.
  • Priorities for increasing LDKT include developing guidelines, streamlining evaluations, and enhancing communication.