How Patients Manage Life and Health While Waiting for a Liver Transplant

2003 ◽  
Vol 13 (1) ◽  
pp. 47-60 ◽  
Author(s):  
M. Susan Baker ◽  
Carol L. McWilliam
Keyword(s):  
Liver Transplantation ◽  
Grounded Theory ◽  
Liver Transplant ◽  
Health Resources ◽  
Waiting Period ◽  
Letting Go ◽  
Successful Transplantation ◽  
Changing Attitudes ◽  
Depth Interviews ◽  
Overall Health Status

Liver transplantation offers a lifesaving treatment for individuals with terminal disease. An extended waiting period may contribute to anxiety and undermine overall health status, jeopardizing the patient's opportunity for successful transplantation. The purpose of this grounded theory qualitative study was to discover how individuals experience life and health resources during the wait for a liver transplant. In-depth interviews, conducted with 12 adults who had awaited liver transplantation for more than a year, were transcribed verbatim and analyzed using grounded theory methods. The findings portrayed the transplant waiting period to be a process of experiencing confinement, disciplining the self, and ultimately letting go and surrendering one's self to accept available, accessible, and appropriate resources for health. Resources for life and health used by the participants included: following instructions, presenting self positively, seeking information and support, controlling symptoms, using distraction and denial, changing attitudes, setting and achieving new goals, isolating oneself and entrusting oneself to another. The findings suggest the importance of increasing supportive, health-oriented care aimed at promoting resources for everyday living and health during the transplant waiting period.

A gap between Law and Practice: A Community’s Perception of Unmarried Women’s Abortion Options in Nepal

2014 ◽  
Vol 12 (2) ◽  
pp. 24-30
Author(s):  
Simone Christensen Hald ◽  
Ditte Aagaard Sondergaard
Keyword(s):  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Safe Abortion ◽  
Community Attitudes ◽  
Abortion Law ◽  
Premarital Sexual Activity ◽  
Premarital Sexual ◽  
The Right ◽  
Changing Attitudes ◽  
Depth Interviews

Background In 2002, the Nepalese abortion law went from being highly restrictive to fully liberal. This study aimed to explore a local community’s perception of the situation for unmarried Nepalese women wanting to practice their legal right to abortion.Methods The study comprised a cross-sectional survey and in-depth interviews with men and women above the age of 16 years living in the Makwanpur District, Nepal. The final data included 55 questionnaires and 16 interviews. The questionnaire data was univariate analysed, while a condensation of meaning analysis was carried out on the interviews.Results The overall awareness of abortion being legal was high, although the extent of knowledge of the specific legal grounds varied. Unmarried women were believed to have access to abortion services, although they risked stigmatisation due to their marital status. The community attitude towards these women having abortions was very negative, hence it differed from the legal acceptance of all women having the right to abortion. This was explained by societal norms on premarital sexual activity. Generally, the participants felt that changing attitudes would be difficult but possible over time.Conclusion A considerable gap exists between the legal acceptance of abortion and community attitudes when it comes to unmarried women as this group encounters barriers when wanting to practice their right. Therefore, these barriers need to be addressed to allow unmarried Nepalese women access to safe abortion services without the risk of being stigmatised.One possible alternative is educational initiatives such as disseminating information vigorously through mass media to create awareness.DOI: http://dx.doi.org/10.3126/hprospect.v12i2.9869 Health Prospect Vol.12(2) 2013: 24-30

Early Progression of Coronary Atherosclerosis in Patients Following Liver Transplantation: Results From the Coronary Atherosclerosis Following Liver Transplant (CALT) Study

2021 ◽  
Vol 30 ◽  
pp. S187
Author(s):  
T. Sampaio Rodrigues ◽  
N. Nerlekar ◽  
P. Gow ◽  
R. Lim ◽  
T. Sampaio Rodrigues ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Coronary Atherosclerosis ◽  
Early Progression

scholarly journals Peritoneal Dialysis After Liver Transplantation: A Systematic Review

2021 ◽  
Vol 8 ◽  
pp. 205435812110297
Author(s):  
Jean Maxime Côté ◽  
Isabelle Ethier ◽  
Héloïse Cardinal ◽  
Marie-Noëlle Pépin
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Kidney Failure ◽  
Liver Graft ◽  
Transplant Recipients ◽  
Technique Survival ◽  
Liver Transplant Recipients

Background: Chronic kidney disease following liver transplantation is a major long-term complication. Most liver transplant recipients with kidney failure will be treated with dialysis instead of kidney transplantation due to noneligibility and shortage in organ availability. In this population, the role of peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) remains unclear. Objective: To determine the feasibility regarding safety, technique survival, and dialysis efficiency of PD in liver transplant recipients requiring KRT for maintenance dialysis. Design: Systematic review. Setting: Interventional and observational studies reporting the use of PD after liver transplantation. Patients: Adult liver transplant recipients with kidney failure treated with maintenance KRT. Measurements: Extracted data included eligibility criteria, study design, demographics, and PD modality. The following outcomes of interest were extracted: rate of peritonitis and microorganisms involved, noninfectious peritoneal complications, technique survival, and kidney transplantation-censored technique survival. Non-PD complications included overall survival, liver graft dysfunction, and hospitalization rate. Methods: The following databases were searched until July 2020: MedLine/PubMed, EMBASE, CINAHL, and Cochrane Library. Two reviewers independently screening all titles and abstracts of all identified articles. Due to the limited sample size, observational designs and study heterogeneity expected, no meta-analysis was pre-planned. Descriptive statistics were used to report all results. Results: From the 5263 identified studies, 4 were included in the analysis as they reported at least 1 outcome of interest on a total of 21 liver transplant recipients, with an overall follow-up duration on PD of 19.0 (Interquartile range [IQR]: 9.5-29.5) months. Fifteen episodes of peritonitis occurred in a total cumulative PD follow-up of 514 patient-months, representing an incidence rate of 0.35 per year. These episodes did not result in PD technique failure, mortality, or impairment of liver graft function. Limitations: Limitations include the paucity of studies in the field and the small number of patients included in each report, a risk of publication bias and the impossibility to directly compare hemodialysis to PD in this population. These results, therefore, must be interpreted with caution. Conclusions: Based on limited data reporting the feasibility of PD in liver transplant recipients with kidney failure, no signal was associated with an increased risk of infectious complications. Long-term studies evaluating this modality need to be performed. Registration (PROSPERO): CRD42020218374.

scholarly journals Risk factors predicting Cytomegalovirus infection in post liver transplant recipients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G Abdelrahman ◽  
H A Mahmoud ◽  
M K Mohsen ◽  
M O Ali ◽  
A M N Mohamed
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Organ Transplantation ◽  
Chronic Rejection ◽  
Cytomegalovirus Infection ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Donor Liver Transplantation ◽  
Liver Transplant Recipients

Abstract Background Liver transplantation is considered to be the only curative treatment for patients with end stage liver disease. Postoperative infection remains to be one of the most common causes of morbidity and mortality throughout the past years. Cytomegalovirus (CMV) infection although considered to be a weak viral infection that usually passes asymptomatic in immunocompetent patients, however, it is considered one of the most common pathogens causing morbidities and mortality in liver transplant recipients. Multiple studies have been done to assess the risk factors for developing CMV infection. Objective Identification of risk factors predicting Cytomegalovirus infection in liver transplant recipients following transplantation. Methods This retrospective study was conducted on 194 patients and their donors who underwent living donor liver transplantation operation at Ain Shams centre for organ transplantation (ASCOT) at Ain Shams specialized hospital in the period between January 2010 and December 2016 with at least one year follow up period after operation for the recipient group. Results In our study, 194 patients undergoing liver transplantation at Ain shams centre for organ transplantation over seven years from January 2010 to December 2016 have been followed to assess risk factors affecting CMV infection development. Chronic rejection was found to be the most common factor associated with CMV infection followed by Cyclosporin (Neoral) as main postoperative immunosuppressant following liver transplantation. Other factors that were found to carry risk for CMV infection included younger age, advanced MELD score, positive CMV IgM status of the donors and recipients. Conclusion Differentiation of Cytomegalovirus disease from Cytomegalovirus infection isn’t always available as it requires tissue invasive techniques. Multiple risk factors have been attributed to cause Cytomegalovirus infection (viremia) . In our study, rejection (chronic rejection) was the factor that carries highest risk for Cytomegalovirus infection development followed by Cyclosporin .

scholarly journals HIV and Liver transplantation: The British Columbia Experience, 2004 to 2013

2014 ◽  
Vol 25 (3) ◽  
pp. 159-162 ◽  
Author(s):  
Clara Tan-Tam ◽  
Pamela Liao ◽  
Julio S Montaner ◽  
Mark W Hull ◽  
Charles H Scudamore ◽  
...  
Keyword(s):  
British Columbia ◽  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Clinical Outcomes ◽  
Disease Status ◽  
Transplant Program ◽  
End Stage

BACKGROUND: The demand for definitive management of end-stage organ disease in HIV-infected Canadians is growing. Until recently, despite international evidence of good clinical outcomes, HIV-infected Canadians with end-stage liver disease were ineligible for transplantation, except in British Columbia (BC), where the liver transplant program of BC Transplant has accepted these patients for referral, assessment, listing and provision of liver allograft. There is a need to evaluate the experience in BC to determine the issues surrounding liver transplantation in HIV-infected patients.METHODS: The present study was a chart review of 28 HIV-infected patients who were referred to BC Transplant for liver transplantation between 2004 and 2013. Data regarding HIV and liver disease status, initial transplant assessment and clinical outcomes were collected.RESULTS: Most patients were BC residents and were assessed by the multidisciplinary team at the BC clinic. The majority had undetectable HIV viral loads, were receiving antiretroviral treatments and were infected with hepatitis C virus (n=16). The most common comorbidities were anxiety and mood disorders (n=4), and hemophilia (n=4). Of the patients eligible for transplantation, four were transplanted for autoimmune hepatitis (5.67 years post-transplant), nonalcoholic steatohepatitis (2.33 years), hepatitis C virus (2.25 years) and hepatitis B-delta virus coinfection (recent transplant). One patient died from acute renal failure while waiting for transplantation. Ten patients died during preassessment and 10 were unsuitable transplant candidates. The most common reason for unsuitability was stable disease not requiring transplantation (n=4).CONCLUSIONS: To date, interdisciplinary care and careful selection of patients have resulted in successful outcomes including the longest living HIV-infected post-liver transplant recipient in Canada.

Normalised intrinsic mortality risk in liver transplantation: European Liver Transplant Registry study

The Lancet ◽  
2000 ◽  
Vol 356 (9230) ◽  
pp. 621-627 ◽  
Author(s):  
René Adam ◽  
Valérie Cailliez ◽  
Pietro Majno ◽  
Vincent Karam ◽  
Paul McMaster ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Mortality Risk ◽  
Registry Study ◽  
Transplant Registry ◽  
Intrinsic Mortality

Filipino Domestic Workers and Their Capacity Development

2016 ◽  
Vol 59 (6) ◽  
pp. 824-841
Author(s):  
Jennifer Loh ◽  
Alicia F. Estrellado
Keyword(s):  
Grounded Theory ◽  
Coping Strategies ◽  
Working Conditions ◽  
Psychological Health ◽  
Personal Characteristics ◽  
Capacity Development ◽  
Domestic Workers ◽  
Depth Interviews

This study explored the day-to-day experiences of female Filipino domestic workers in Singapore, including their working conditions, employee–employer relationships, and psychological health. In-depth interviews were conducted with 18 women. Using grounded theory, the emergent themes revealed high levels of variation, both within and between women, suggesting that the quality of domestic workers’ lives depends largely on the personal characteristics of their employers or the workers themselves, rather than on any system of protection. More importantly, participants displayed positive and resilient coping strategies which enabled them to thrive despite restrictive circumstances. Implications pertaining to capabilities and empowerment development were discussed.

What Happens When Adequate Vascular Access Cannot Be Provided for Major Surgery (Liver Transplantation)?

2019 ◽  
Vol 24 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Zoka Milan ◽  
Sanjay Agrawal ◽  
Katyayani Katyayani ◽  
Nikhil Sharma
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Vascular Access ◽  
Early Stage ◽  
Major Surgery ◽  
Early Age ◽  
Large Vein ◽  
Central Access

Highlights Although not traditionally accepted as a viable central access during liver transplant, this case illustrates that in certain situations femoral central access can be successful When dealing with patients who require constant vascular access from a very early age, potential large vein thromboses should be considered Thromboprophylaxis initiation should be considered at a very early stage

Sign in / Sign up

Export Citation Format

Share Document