Compatible Donor and Recipient Pairs’ Perspectives on Participation in Kidney Paired Donation Programs: A Mixed-Methods Study

Background: Compatible pair participation in kidney paired donation (KPD) may increase the likelihood of finding suitable matches for all registered pairs. Retrospective studies have shown variable enthusiasm for participating in KPD in compatible pairs. Objective: The study objective was to gather potential living donor (PLD) and transplant candidate (TC) perspectives on compatible pair participation in KPD. Design: Surveys and qualitative interviews. Setting: Three transplant programs in Canada: Centre hospitalier de l’Université de Montréal in Montreal (Québec), Vancouver General Hospital, and St. Paul’s Hospital in Vancouver (British Columbia). Patients: Both PLDs and TCs undergoing evaluation for donation/transplantation between 2016 and 2018 at 3 transplant programs in Canada. Methods: Descriptive statistical analysis was performed for the results of the survey and thematic and content analysis method was used for the content of the qualitative interviews. Results: A total of 116 PLDs and 111 TCs completed surveys and an additional 18 PLDs and 17 TCs underwent semi-directed interviews. Of those surveyed, 61.2% of PLDs and 76.6% of TCs reported a willingness to participate in KPD as a compatible pair. The possibility of a more optimally matched kidney for the TC and policies ensuring prioritization of the TC for repeat transplantation in the event of early graft failure increased willingness to participate in KPD. Major concerns expressed during the interviews included the desire to retain the emotional bond of directed donation, the fear of chain breaks or donor reneging, delays in transplantation, and additional travel associated with participation in KPD. Limitation: The limitations of this study are that it was conducted in only 3 Canadian transplant programs and that the interviews and surveys were in French and in English. As a consequence, the results may not be reflective of the views of individuals not living in these 2 provinces and from ethnic minority populations. Conclusion: Most of the compatible PLDs and TCs surveyed were willing to participate in KPD. Ensuring timely transplantation and a more optimal match for TCs and offering a policy of reciprocity to ensure timely repeat transplantation for compatible recipients if their allograft fails post KPD transplant may further increase compatible pair participation in KPD.

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Platelet Adhesion in Polytetrafluoroethylene (PTFE) Vascular Grafts In Vivo and the Influence of Increased Intramuscular Pressure-An Experimental Model

Thrombosis and Haemostasis ◽

10.1055/s-0038-1665334 ◽

1983 ◽

Vol 50 (04) ◽

pp. 881-884 ◽

Cited By ~ 3

Author(s):

J T Christenson ◽

P Qvarfordt ◽

S-E Strand ◽

D Arvidsson ◽

T Sjöberg ◽

...

Keyword(s):

Blood Flow ◽

Graft Failure ◽

Small Diameter ◽

Graft Material ◽

Intramuscular Pressure ◽

Initial Flow ◽

Early Graft ◽

Wick Technique ◽

Early Graft Failure

SummaryThrombogenicity of graft material is involved in early graft failure in small diameter grafts. The frequently seen postoperative swelling of the leg after distal revascularization may cause an increased intramuscular pressure and early graft failure.Pairs of 4 mm polytetrafluoroethylene (PTFE) grafts were implanted. Autologous platelets were labeled with mIn-oxine. Platelet adhesiveness onto the grafts were analyzed from gamma camera images. Intramuscular pressures were measured with wick technique. Blood flow was measured. One graft served as control the other as test graft. Ninety minutes after declamping the i. m. pressure was increased in the test-leg to 30 mmHg, and later to 60 mmHg.In the control-graft platelet uptake increased to a maximum 60 min after declamping. Blood flow and i.m. pressure remained uneffected. The test-grafts were initially similar but when i.m. pressure was increased to 30 mmHg activity in the grafts increased significantly. Blood flow decreased with 12% of initial flow. When i. m. pressure was raised to 60 mmHg platelet uptake continued to increase.An increased intramuscular pressure of 30 mmHg or more significantly increase the amount of platelets adhering onto PTFE grafts, emphasizing the need for measuring intramuscular pressures after lower limb vascular revascularizations.

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Correlation of laboratory and ECG changes with early graft failure after CABG

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2005-862132 ◽

2005 ◽

Vol 53 (S 01) ◽

Author(s):

A Schnell ◽

A Künzli ◽

B Seifert ◽

O Reuthebuch ◽

M Lachat ◽

...

Keyword(s):

Graft Failure ◽

Ecg Changes ◽

Early Graft ◽

Early Graft Failure

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Virchow Triad, but Not Use of an Aortic Connector Device, Predicts Early Graft Failure after Off-Pump Coronary Bypass

The Heart Surgery Forum ◽

10.1532/hsf98.20041090 ◽

2004 ◽

Vol 7 (5) ◽

pp. E428-E433 ◽

Cited By ~ 5

Author(s):

Robert Poston ◽

Charles White ◽

Katrina Read ◽

Junyan Gu ◽

Andrew Lee ◽

...

Keyword(s):

Graft Failure ◽

Coronary Bypass ◽

Off Pump ◽

Early Graft ◽

Early Graft Failure ◽

Aortic Connector

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Faculty Opinions recommendation of Predictors of early graft failure after infrainguinal bypass surgery: a risk-adjusted analysis from the NSQIP.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13950006.15405126 ◽

2012 ◽

Author(s):

Norman Hertzer

Keyword(s):

Graft Failure ◽

Bypass Surgery ◽

Adjusted Analysis ◽

Infrainguinal Bypass ◽

Early Graft ◽

Early Graft Failure

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Prediction model for early graft failure after liver transplantation using aspartate aminotransferase, total bilirubin and coagulation factor

Scientific Reports ◽

10.1038/s41598-021-92298-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jinsoo Rhu ◽

Jong Man Kim ◽

Kyunga Kim ◽

Heejin Yoo ◽

Gyu-Seong Choi ◽

...

Keyword(s):

Liver Transplantation ◽

Prediction Model ◽

Aspartate Aminotransferase ◽

Graft Failure ◽

Living Donor ◽

Total Bilirubin ◽

Deceased Donor ◽

Time Dependent ◽

Early Graft ◽

Early Graft Failure

AbstractThis study was designed to build models predicting early graft failure after liver transplantation. Cox regression model for predicting early graft failure after liver transplantation using post-transplantation aspartate aminotransferase, total bilirubin, and international normalized ratio of prothrombin time was constructed based on data from both living donor (n = 1153) and deceased donor (n = 359) liver transplantation performed during 2004 to 2018. The model was compared with Model for Early Allograft Function Scoring (MEAF) and early allograft dysfunction (EAD) with their C-index and time-dependent area-under-curve (AUC). The C-index of the model for living donor (0.73, CI = 0.67–0.79) was significantly higher compared to those of both MEAF (0.69, P = 0.03) and EAD (0.66, P = 0.001) while C-index for deceased donor (0.74, CI = 0.65–0.83) was only significantly higher compared to C-index of EAD. (0.66, P = 0.002) Time-dependent AUC at 2 weeks of living donor (0.96, CI = 0.91–1.00) and deceased donor (0.98, CI = 0.96–1.00) were significantly higher compared to those of EAD. (both 0.83, P < 0.001 for living donor and deceased donor) Time-dependent AUC at 4 weeks of living donor (0.93, CI = 0.86–0.99) was significantly higher compared to those of both MEAF (0.87, P = 0.02) and EAD. (0.84, P = 0.02) Time-dependent AUC at 4 weeks of deceased donor (0.94, CI = 0.89–1.00) was significantly higher compared to both MEAF (0.82, P = 0.02) and EAD. (0.81, P < 0.001). The prediction model for early graft failure after liver transplantation showed high predictability and validity with higher predictability compared to traditional models for both living donor and deceased donor liver transplantation.

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Can social support work virtually? Evaluation of rheumatoid arthritis patients’ experiences with an interactive online tool

Pain Research and Management ◽

10.1155/2015/497512 ◽

2015 ◽

Vol 20 (4) ◽

pp. 199-209 ◽

Cited By ~ 7

Author(s):

Zlatina Kostova ◽

Maria Caiata-Zufferey ◽

Peter J Schulz

Keyword(s):

Rheumatoid Arthritis ◽

Social Support ◽

Positive Impact ◽

Qualitative Interviews ◽

General Purpose ◽

Individual Characteristics ◽

Willingness To Participate ◽

Chronic Patients ◽

Support Tool ◽

Psychological Suffering

BACKGROUND: There is strong empirical evidence that the support that chronic patients receive from their environment is fundamental for the way they cope with physical and psychological suffering. Nevertheless, in the case of rheumatoid arthritis (RA), providing the appropriate social support is still a challenge, and such support has often proven to be elusive and unreliable in helping patients to manage the disease.OBJECTIVES: To explore whether and how social support for RA patients can be provided online, and to assess the conditions under which such support is effective. An online support tool was designed to provide patients with both tailored information and opportunities to interact online with health professionals and fellow sufferers. The general purpose was to identify where the support provided did – or did not – help patients, and to judge whether the determinants of success lay more within patients – their engagement and willingness to participate – or within the design of the website itself.METHODS: The present study reports qualitative interviews with 19 users of the tool. A more specific purpose was to elaborate qualitatively on results from a quantitative survey of users, which indicated that any positive impact was confined to practical matters of pain management rather than extending to more fundamental psychological outcomes such as acceptance.RESULTS AND CONCLUSIONS: Overall, online learning and interaction can do much to help patients with the everyday stresses of their disease; however, its potential for more durable positive impact depends on various individual characteristics such as personality traits, existing social networks, and the severity and longevity of the disease.

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217 Transplant Renal Artery Stenosis: An Important Cause of Early Graft Failure

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2021.02.222 ◽

2021 ◽

Vol 77 (4) ◽

pp. 636

Keyword(s):

Renal Artery ◽

Renal Artery Stenosis ◽

Graft Failure ◽

Artery Stenosis ◽

Transplant Renal Artery Stenosis ◽

Early Graft ◽

Early Graft Failure

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To jump or not to jump? A multicentre propensity-matched study of sequential vein grafting of the heart

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz042 ◽

2019 ◽

Vol 29 (2) ◽

pp. 201-208 ◽

Cited By ~ 1

Author(s):

Jens K Skov ◽

Hans-Henrik Kimose ◽

Jacob Greisen ◽

Carl-Johan Jakobsen

Keyword(s):

Artery Bypass ◽

Postoperative Bleeding ◽

Study Groups ◽

Confidence Limits ◽

Risk Of Mortality ◽

Increased Risk ◽

Early Graft ◽

Matched Study ◽

Early Graft Failure

AbstractOBJECTIVESIn this propensity-matched study we investigated the outcome after grafting with either a single vein or a sequential vein grafting strategy. Outcomes were primarily risk of reintervention and death in the short, intermediate and long term (10 years).MATERIALSIn the period from 2000 to 2016, data from 24 742 patients undergoing coronary artery bypass grafting were extracted from the Western Denmark Heart Registry, where data are registered perioperatively. We used a propensity-matched study in which the study groups were matched on parameters primarily from the EuroSCORE. The numbers of patients in both groups after matching were 3380.RESULTSSingle grafts resulted in significantly more postoperative bleeding and were more time-consuming. No differences were seen regarding in-hospital events such as stroke, acute myocardial infarction, dialysis or arrhythmias. After 30 days, patients in the jump graft group showed an increased rate of reintervention due to ischaemia after adjusting for confounding factors [hazard ratio (HR) 2.08, 95% confidence interval 1.01–4.34]. In addition, after adjusting for known confounders, sequential grafts were found to increase the risk of mortality at 6 months (HR 1.51, 95% confidence limits 1.07–2.11) and 5 years (HR 1.23, 95% confidence limits 1.04–1.46).CONCLUSIONSThis propensity-matched analysis suggested, although discretely, that a jump graft as a grafting strategy is associated with a slightly increased risk of mortality and early graft failure and that a single grafting strategy to the coronary arteries should be preferred when feasible.

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