Improving Public Awareness of Organ Transplantation in Japan

2000 ◽  
Vol 10 (1) ◽  
pp. 56-59 ◽  
Author(s):  
Yoshiaki Kita ◽  
Yoshio Aranami ◽  
Yoshi Aranami ◽  
Yushi Nomura ◽  
Karin Johnson ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Public Awareness ◽  
Organ Transplant ◽  
Fund Raising ◽  
International Organization ◽  
Mutual Aid ◽  
Transplant Recipients ◽  
Early Passage ◽  
The Public ◽  
Transplant Candidates

The goals of the Japanese chapter of the Transplant Recipients International Organization are to act as a mediator in the provision of mutual aid to transplant recipients, candidates, and their families and to provide education in both the public and professional arenas to promote organ transplantation in Japan. Since 1991, members of the Japanese chapter of the Transplant Recipients International Organization have acted as volunteer facilitators for more than 150 transplant candidates and recipients. The organization's activities have included fund-raising to cover the costs of transplantation, preparing an original donor card for distribution, and petitioning members of the Diet (the Japanese legislative body) 14 times, including speaking at public hearings twice and submitting a petition requesting early passage of the organ transplant bill. The Japanese Diet finally passed an organ transplant bill in June 1997. The activities of the Japanese chapter of the Transplant Recipients International Organization have contributed to the promotion of organ transplantation in Japan and to understanding and support for transplantation within the Japanese community as a whole.

Resurrected Bodies

2010 ◽  
Vol 39 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Arlene Macdonald
Keyword(s):  
Public Policy ◽  
Lived Experience ◽  
Organ Transplant ◽  
Transplant Recipients ◽  
Ethical Considerations ◽  
The Public ◽  
Professional Activities ◽  
Faith Traditions ◽  
Anthropological Literature ◽  
Religious Actors

The anthropological literature on transplant, though theoretically and ethnographically rich, does not address religion in any substantial way. And while bio-ethical considerations of transplant regularly address religion, treatments are generally circumscribed to a list of various faith traditions and their stance toward organ transplant. Such a presentation reduces “religion” to the world’s recognized faith traditions, “religious actors” to the official spokespersons of these traditions, and “religious belief” to moral injunctions. The objective of the thesis was to illuminate the prominent place of religion in the lived experience of transplant recipients and donors, in the public policy and professional activities of transplant officials, and in the transplant discourses of North America

Cytomegalovirus in Solid Organ Transplant Recipients: Clinical Updates, Challenges and Future Directions

2020 ◽  
Vol 26 (28) ◽  
pp. 3497-3506
Author(s):  
Raymund R. Razonable
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Future Directions ◽  
Prevention And Treatment ◽  
Solid Organ Transplant Recipients

Cytomegalovirus is the classic opportunistic infection after solid organ transplantation. This review will discuss updates and future directions in the diagnosis, prevention and treatment of CMV infection in solid organ transplant recipients. Antiviral prophylaxis and pre-emptive therapy are the mainstays of CMV prevention, but they should not be mutually exclusive and each strategy should be considered depending on a specific situation. The lack of a widely applicable viral load threshold for diagnosis and preemptive therapy is emphasized as a major factor that should pave the way for an individualized approach to prevention. Valganciclovir and intravenous ganciclovir remain as drugs of choice for CMV management, and strategies for managing drug-resistant CMV infection are enumerated. There is increasing use of CMV-specific cell-mediated immune assays to stratify the risk of CMV infection after solid organ transplantation, and their potential role in optimizing CMV prevention and treatment efforts is discussed.

Neurocognitive Effects of Solid Organ Transplantation

2010 ◽  
Author(s):  
Nataliya Zelikovsky ◽  
Debra S. Lefkowitz
Keyword(s):  
Organ Transplantation ◽  
Survival Rates ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Chronic Illnesses ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Neurocognitive Outcomes ◽  
Medical Advances

The first successful organ transplant was a kidney transplant performed between identical twins in 1954. Since that time, major medical advances have been made to help improve survival rates for transplant recipients. In 2008, there were 1,964 solid organ transplants performed for children under age 18 (2007 Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients [OPTN/SRTR] Annual Report 1997–2006). Currently, approximately 1,830 pediatric patients are awaiting some type of solid organ transplant (2007 OPTN/SRTR Annual Report 1997–2006). Organ transplantation in children is relatively recent compared to other treatments for children with chronic illnesses. The focus over the first few decades has been on medical advances and improving survival rates for transplant patients. In the recent years, increasing attention has been given to the developmental, neurocognitive, and psychosocial outcomes prior to transplant and in the short-term period post transplant. Most chronic illnesses and acute traumatic medical events have implications for neurocognitive outcomes. End-stage disease of the liver, kidney, heart, and lung are all believed to affect intellectual, academic, and neurocognitive functions. Gross neurodevelopmental deficits have become less common due to early medical intervention (e.g., improved nutrition, surgical intervention, reduced exposure to aluminum (Warady 2002). Organ transplantation is believed to ameliorate the deleterious long-term developmental and neurocognitive effects, but this topic has received little attention in the literature, and the available results with regard to intellectual, academic, and neurodevelopmental results have been mixed. In a combined sample of solid organ transplant patients, 40% had clinically significant cognitive delays (Brosig et al. 2006). Examining the impact of different underlying disease processes and transplantation of each solid organ separately is critical. Thus, we discuss the neurocognitive outcomes of each organ group separately in this chapter. Neurocognitive outcomes can be assessed in a variety of ways depending upon the age of the child. Among infants and toddlers, neurocognitive functioning is measured by an assessment of motor function, social and environmental interaction, and language development. Assessment of older children may involve the evaluation of intelligence, academic achievement, emotional and behavioral functioning, and adaptive skills.

scholarly journals Muslim transplant recipients’ family experiences following organ transplantation

2019 ◽  
Vol 24 (5) ◽  
pp. 291-302
Author(s):  
Zahra Sheikhalipour ◽  
Vahid Zamanzadeh ◽  
Leili Borimnejad ◽  
Sarah E Newton ◽  
Leila Valizadeh
Keyword(s):  
Transplant Recipient ◽  
Organ Transplantation ◽  
Family Relationships ◽  
Organ Transplant ◽  
Phenomenological Approach ◽  
Transplant Recipients ◽  
Structured Interviews ◽  
Family Experience ◽  
Family Experiences ◽  
The Family

Background Despite the importance of family and its relationship to positive transplant outcomes, little is known about family experiences following organ transplantation from the perspective of the transplant recipients. The literature is also devoid of information that describes the family experiences of Muslim transplant recipients. Aims The purpose of this study was to describe Muslim transplant recipients’ family experiences following organ transplantation. Methods A hermeneutical phenomenological approach was employed to determine the emergent themes present in the data. The sample was composed of 12 Muslim organ transplant recipients (heart, kidney and liver) living in Iran. Semi-structured interviews were conducted with each participant. Results The primary constitutive pattern that emerged from the interview data was ‘Altered Family Relationships’ and three themes: fear in relationships, abnormal relationships, and the family at the centre of organ transplant issues. Conclusions There are several important findings in this study, notably that Muslim transplant recipients describe their family experiences following organ transplantation as ‘altered’ and not as they were pre-transplant. More research is needed that focuses on the family experience post-transplant, and how Muslim transplant recipient families are impacted by the transplant experience.

scholarly journals Prevention of Fractures after Solid Organ Transplantation: A Meta-Analysis

2011 ◽  
Vol 96 (11) ◽  
pp. 3457-3465 ◽  
Author(s):  
Emily M. Stein ◽  
Dionisio Ortiz ◽  
Zhezhen Jin ◽  
Donald J. McMahon ◽  
Elizabeth Shane
Keyword(s):  
Bone Loss ◽  
Organ Transplantation ◽  
Vertebral Fractures ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Cochrane Library ◽  
First Year ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Mineral Density

Abstract Context: Bone loss and fracture are serious sequelae of organ transplantation, particularly in the first posttransplant year. Most interventional studies have been inadequately powered to detect effects on fracture. Objective: The objective of the study was to determine whether treatment with bisphosphonates (BP) or active vitamin D analogs (vitD) during the first year after transplantation reduces fracture risk and estimate the effect of these interventions on bone loss. Data Sources: Sources included PUBMED, MEDLINE, Cochrane Library, and abstracts from scientific meetings (presented 2003–2010). Study Selection: Randomized controlled clinical trials of BP or vitD in solid organ transplant recipients were included if treatment was initiated at the time of transplantation and fracture data were collected. Data Extraction: Two investigators independently extracted data and rated study quality. Fixed effect and random-effects models were used to obtain pooled estimates. Data Synthesis: Eleven studies of 780 transplant recipients (134 fractures) were included. Treatment with BP or vitD reduced the number of subjects with fracture [odds ratio (OR) 0.50 (0.29, 0.83)] and number of vertebral fractures, [OR 0.24 (0.07, 0.78)]. An increase in bone mineral density at the lumbar spine [2.98% (1.31, 4.64)] and femoral neck [3.05% (2.16, 3.93)] was found with treatment. When BP trials (nine studies, 625 subjects) were examined separately, there was a reduction in number of subjects with fractures [OR 0.53 (0.30, 0.91)] but no significant reduction in vertebral fractures [OR 0.34 (0.09, 1.24)]. Conclusions: Treatment with BP or vitD during the first year after solid organ transplant was associated with a reduction in the number of subjects with fractures and fewer vertebral fractures.

scholarly journals Development of Phenotyping Algorithms for the Identification of Organ Transplant Recipients: Cohort Study

10.2196/18001 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e18001
Author(s):  
Lee Wheless ◽  
Laura Baker ◽  
LaVar Edwards ◽  
Nimay Anand ◽  
Kelly Birdwell ◽  
...  
Keyword(s):  
Machine Learning ◽  
Electronic Health Records ◽  
Organ Transplantation ◽  
Learning Algorithms ◽  
Organ Transplant ◽  
Machine Learning Algorithms ◽  
Transplant Recipients ◽  
Health Records ◽  
Organ Transplant Recipients ◽  
Electronic Health

Background Studies involving organ transplant recipients (OTRs) are often limited to the variables collected in the national Scientific Registry of Transplant Recipients database. Electronic health records contain additional variables that can augment this data source if OTRs can be identified accurately. Objective The aim of this study was to develop phenotyping algorithms to identify OTRs from electronic health records. Methods We used Vanderbilt’s deidentified version of its electronic health record database, which contains nearly 3 million subjects, to develop algorithms to identify OTRs. We identified all 19,817 individuals with at least one International Classification of Diseases (ICD) or Current Procedural Terminology (CPT) code for organ transplantation. We performed a chart review on 1350 randomly selected individuals to determine the transplant status. We constructed machine learning models to calculate positive predictive values and sensitivity for combinations of codes by using classification and regression trees, random forest, and extreme gradient boosting algorithms. Results Of the 1350 reviewed patient charts, 827 were organ transplant recipients while 511 had no record of a transplant, and 12 were equivocal. Most patients with only 1 or 2 transplant codes did not have a transplant. The most common reasons for being labeled a nontransplant patient were the lack of data (229/511, 44.8%) or the patient being evaluated for an organ transplant (174/511, 34.1%). All 3 machine learning algorithms identified OTRs with overall >90% positive predictive value and >88% sensitivity. Conclusions Electronic health records linked to biobanks are increasingly used to conduct large-scale studies but have not been well-utilized in organ transplantation research. We present rigorously evaluated methods for phenotyping OTRs from electronic health records that will enable the use of the full spectrum of clinical data in transplant research. Using several different machine learning algorithms, we were able to identify transplant cases with high accuracy by using only ICD and CPT codes.

scholarly journals Development of Phenotyping Algorithms for the Identification of Organ Transplant Recipients: Cohort Study (Preprint)

2020 ◽  
Author(s):  
Lee Wheless ◽  
Laura Baker ◽  
LaVar Edwards ◽  
Nimay Anand ◽  
Kelly Birdwell ◽  
...  
Keyword(s):  
Machine Learning ◽  
Electronic Health Records ◽  
Organ Transplantation ◽  
Learning Algorithms ◽  
Organ Transplant ◽  
Machine Learning Algorithms ◽  
Transplant Recipients ◽  
Health Records ◽  
Organ Transplant Recipients ◽  
Electronic Health

BACKGROUND Studies involving organ transplant recipients (OTRs) are often limited to the variables collected in the national Scientific Registry of Transplant Recipients database. Electronic health records contain additional variables that can augment this data source if OTRs can be identified accurately. OBJECTIVE The aim of this study was to develop phenotyping algorithms to identify OTRs from electronic health records. METHODS We used Vanderbilt’s deidentified version of its electronic health record database, which contains nearly 3 million subjects, to develop algorithms to identify OTRs. We identified all 19,817 individuals with at least one International Classification of Diseases (ICD) or Current Procedural Terminology (CPT) code for organ transplantation. We performed a chart review on 1350 randomly selected individuals to determine the transplant status. We constructed machine learning models to calculate positive predictive values and sensitivity for combinations of codes by using classification and regression trees, random forest, and extreme gradient boosting algorithms. RESULTS Of the 1350 reviewed patient charts, 827 were organ transplant recipients while 511 had no record of a transplant, and 12 were equivocal. Most patients with only 1 or 2 transplant codes did not have a transplant. The most common reasons for being labeled a nontransplant patient were the lack of data (229/511, 44.8%) or the patient being evaluated for an organ transplant (174/511, 34.1%). All 3 machine learning algorithms identified OTRs with overall >90% positive predictive value and >88% sensitivity. CONCLUSIONS Electronic health records linked to biobanks are increasingly used to conduct large-scale studies but have not been well-utilized in organ transplantation research. We present rigorously evaluated methods for phenotyping OTRs from electronic health records that will enable the use of the full spectrum of clinical data in transplant research. Using several different machine learning algorithms, we were able to identify transplant cases with high accuracy by using only ICD and CPT codes.

scholarly journals Solid organ transplantation and pregnancy

2021 ◽  
Vol 4 (4) ◽  
pp. 333-338
Author(s):  
M.A. Lysenko ◽  
◽  
P.V. Kozlov ◽  
V.M. Grabovskiy ◽  
I.Yu. Kokaya ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Postnatal Period ◽  
Current Data ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Liver And Kidney

This paper highlights the management of pregnancy, delivery, and the postpartum period after solid organ transplantation. First, statistical data on the prevalence and pattern of organ transplantation are addressed. The most relevant issues of pregnancy management in organ transplant recipients include identifying optimal criteria of transplant function monitoring, assessment of pregnancy and medication effects on the fetus, and pregnancy complication development. Next, the authors review major pharmacological classes of immunosuppressive therapy, pregnancy risks, complications, and outcomes associated with these medications, relevant pregnancy planning and management issues, and delivery in liver and kidney transplant recipients. Finally, the effect of breastfeeding (in the context of regular immunosuppressive therapy) on the postnatal period is discussed. Current data demonstrate that favorable pregnancy outcome after organ transplantation is most likely at least one year after transplantation in case of stable organ functioning, careful monitoring of recipient and transplant, adequate immunosuppressive therapy, diagnostic monitoring of fetus throughout pregnancy, and timely delivery. KEYWORDS: pregnancy, transplantation, liver, kidney, immunosuppressive therapy, complications, breastfeeding. FOR CITATION: Lysenko M.A., Kozlov P.V., Grabovskiy V.M. et al. Solid organ transplantation and pregnancy. Russian Journal of Woman and Child Health. 2021;4(4):333–338 (in Russ.). DOI: 10.32364/2618-8430-2021-4-4-333-338.

The Effects of Religious and Cultural Beliefs on Muslim Transplant Candidates During the Pretransplant Waiting Period

2018 ◽  
Vol 32 (1) ◽  
pp. 82-95
Author(s):  
Zahra Sheikhalipour ◽  
Vahid Zamanzadeh ◽  
Leili Borimnejad ◽  
Leila Valizadeh ◽  
Sarah Newton ◽  
...  
Keyword(s):  
Lived Experience ◽  
Organ Transplantation ◽  
Health Care Providers ◽  
Cultural Beliefs ◽  
Organ Transplant ◽  
Phenomenological Approach ◽  
Patient Specific ◽  
Care Providers ◽  
Waiting Period ◽  
Transplant Candidates

Background:Awaiting organ transplantation can be stressful, and pretransplant candidates’ religious and cultural beliefs can influence how they adapt to the stress. While little is known about the effect religious and cultural beliefs have on the pretransplant waiting period, virtually nothing is known regarding whether and how Shia Muslim patients’ religious and cultural beliefs facilitate more positive patient outcomes while they await transplantation. Therefore, it is important for nurses and other health care providers to understand transplant candidates’ experiences dealing with the stressors that present themselves during the pretransplant waiting period, especially how their religious and cultural beliefs affect their adaptation to the stressors.Aim:The purpose of this study was to explore the lived experience of Shia Muslim organ transplant candidates regarding how their religious and cultural beliefs affect their adaptation to the pretransplant waiting period.Sample:A purposeful sample of 11 Shia Muslim organ transplant candidates who were on an organ transplant waiting list in Iran (kidney,n= 4; heart,n= 4; liver,n= 3) was recruited.Method:A qualitative research design using the hermeneutical phenomenological approach was utilized in this study. In-depth unstructured interviews were conducted by one of the authors (ZS) in different locations across Iran.Results:Data analysis led to the development of six themes: “the misty road of organ transplantation,” “to accede to organ transplantation despite religious conflict,” “one step away from death,” “the master key of liberation,” “fear of the unknown,” and “reliance on God.”Nursing Implications:The findings of this study will help nurses understand the religious and cultural meaning associated with stressors experienced by Shia Muslim patients awaiting organ transplant. This information can assist nurses to develop plans of care that include patient-specific interventions that take into consideration the patients’ religious and cultural beliefs.Conclusion:Shia Muslim patients awaiting organ transplantation experience feelings that are often in conflict with their religious and cultural beliefs. However, the patients’ reliance on God during the pretransplant waiting period facilitated healthier attitudes regarding transplantation.

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