Each year, 800 people wait for an organ transplant in Sweden. The development of drugs for organ rejection has evolved over the past 60 years, which has increased the survival of patients who have undergone organ transplantation. The most common organ transplanted is the kidney, liver, lung and heart. There are more studies done on quality of life after an organ transplant, but very few studies on quality of life before organ transplantation. The aim of the study was to describe the experiences of quality of life among patients waiting for an organ transplant. A literature overview of eight articles was analyzed in both similarities and differences. The articles were published between 2002 and 2012. The result is presented in four themes, hope of life, living in uncertainty, the body fails and need for support. In some of the themes subthemes were found. Most themes affected quality of life in a negative way. Stress and anxiety were two factors that many patients described as a cause of low quality of life. Many patients described the waiting time as living in uncertainty. Various disease symptoms showed differently depending on the underlying disease. Results showed that patients waiting for an organ transplant have a low quality of life but only a few studies showed that these patients, despite their disease, could feel joy.

Bakgrund: Antalet individer som lever med ett transplanterat organ ökar. Transplantation innebär att ersätta ett sviktande organ med ett friskt fungerande organ från en donator. En transplantation innebär en förändring av livet. Sjuksköterskan har ansvar för undervisning och stöd för patienten samt etablering av en fortsatt vårdkontakt. Syfte: Syftet var att beskriva patientens upplevelse av att leva med ett transplanterat organ. Metod: En litteraturöversikt har genomförts och grundats på tio kvalitativa artiklar från olika databaser som besvarar syftet. Analysen av artiklarna ledde till subteman och teman som presenteras i litteraturöversiktens resultatdel. Litteraturöversikten har begränsats till att enbart innefatta transplantation av organen hjärta, lungor, lever och njurar. Resultat: Resultatet presenteras i fyra teman och fem subteman. De fyra teman är En förändrad kropp, Leva med konsekvenserna av medicinering, En emotionell berg- och dalbana och Att leva vidare. Patienterna upplevde en kroppslig förändring samt paradoxala känslor kring transplantationen. Hinder och möjligheter upplevde de transplanterade i återhämtningsprocessen samt konsekvenser som de var tvungna att leva med. I resultatet framkom vilken betydande roll sjuksköterskan, sjukvården och närstående har för patienten. Att genomgå en transplantation innebär en anpassning till en ny situation med livsstilsförändringar. Diskussion: I resultatdiskussionen används Husserls livsvärldsteori som teoretisk referensram. Patienterna upplevde en förändrad livsvärld och ett behov av att anpassa sig till det nya livet som ett transplanterat organ medförde. / Background: The number of individuals living with a transplanted organ is increasing. A transplant involves replacing a failing organ with a healthy functioning organ from a donor. A transplant involves a change of life. The nurse is responsible to educate and to support the patient and the establishment of a continuing care contact. Aim: The aim was to describe the patient´s experience of living with a transplanted organ. Method: A literature review has been conducted based on ten articles from different databases that will give answers the aim of the essay. The analysis of the articles led to subthemes and themes which are presented in this literature review result section. This literature review has been limited to only include the transplantation of organs heart, lungs, liver and kidneys. Results: The result are presented in four teams and five subthemes. The four themes are A changed body, Live with the consequences of medication, An emotional roller coaster and Live on. Patients experienced a bodily change and also paradoxical emotions related to the transplantation. The patients experienced obstacles and opportunities during the recovery process and also had to live with other consequences of the transplant. The results showed that the nurse, the health care received and close relatives played a significant role for the patient. A transplantation is an adaption to a new situation with lifestyle changes. Discussion: In the result discussion Husserl’s life-theory is used as a theoretical framework. Patient experienced a great change and needed to adapt to a new life, which the transplanted organ caused.

Dissertação(mestrado) - Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2011. / Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2012-10-29T16:51:37Z No. of bitstreams: 1 josianecapellaro.pdf-2011.pdf: 2197624 bytes, checksum: 0c9a5e0d0181267847c20b2f3106eef7 (MD5) / Approved for entry into archive by Bruna Vieira(bruninha_vieira@ibest.com.br) on 2013-07-15T18:43:38Z (GMT) No. of bitstreams: 1 josianecapellaro.pdf-2011.pdf: 2197624 bytes, checksum: 0c9a5e0d0181267847c20b2f3106eef7 (MD5) / Made available in DSpace on 2013-07-15T18:43:38Z (GMT). No. of bitstreams: 1 josianecapellaro.pdf-2011.pdf: 2197624 bytes, checksum: 0c9a5e0d0181267847c20b2f3106eef7 (MD5) Previous issue date: 2011 / A atuação de uma Comissão Intra-Hospitalar de Doação de Órgãos e Tecidos para Transplante(CIHDOTT) possibilita o efetivo processo de captação e doação de órgãos, faz-se necessário tanto para favorecer as atividades de identificação de possíveis doadores, implementar protocolos, testes diagnósticos, comprovar a existência de morte encefálica(ME)e notificá-la, quanto para sensibilizar a família, reduzindo possíveis obstáculos à efetivação de transplantes no Brasil. OBJETIVO: Conhecer a vivência da CIHDOTT de uma instituição hospitalar do extremo sul do Brasil. MÉTODO: Utilizou-se uma abordagem qualitativa. Obteve-se a aprovação do CEPAS, mediante o Parecer: 63/09. A coleta de dados foi realizada com 11 (onze) membros de uma comissão através de entrevista composta por questões abertas. A análise e a inter-relação dos dados foram realizadas a partir da organização e da extração do seu significado na pesquisa, emergindo o capítulo denominado A vivência como Integrante de uma Comissão Intra-Hospitalar de Doação de Órgãos e Tecidos para Transplante (CIHDOTT), do qual emergiram as seguintes categorias: Inserção dos trabalhadores na implantação e implementação da CIHDOTT; O ingresso na CIHDOTT; Significados atribuídos pelos trabalhadores acerca de sua participação na CIHDOTT; Fatores que favoreceram o trabalho da equipe; Fatores que dificultaram o trabalho da equipe; Estratégias utilizadas pela CIHDOTT no processo de doação-transplante no HU; Contribuições do adequado funcionamento da comissão; Questões éticas presentes no desempenho das atividades dos trabalhadores. Assim, esta pesquisa proporcionou, além de conhecer, também, refletir sobre as práticas da equipe de saúde e suas vivências na CIHDOTT. A maioria dos seus integrantes mostra-se comprometida e engajada na busca de melhores resultados de doações, contribuindo de modo favorável no processo, especialmente com relação à interação entre equipe de saúde, famílias de potenciais doadores e população. Acreditar e agir com atitudes éticas e solidárias no processo de transplante e doação; compreender e respeitar a autonomia das famílias em decidir sobre a doação, torna-se fundamental para um processo de captação tranqüilo, para que haja uma experiência positiva tanto para a equipe de saúde como para os familiares. / The Intra-Hospital Commission for Organ and Tissue Donation for Transplantation (CIHDOTT) enables effective organ acquisition and processing which is necessary not only to help identify potential donors, implement protocols, run diagnostic tests, verify brain death(BD), but also to educate families and thus reduce potential obstacles to transplantation in Brazil. OBJECTIVE: To learn about the experiences of CIHDOTT at a hospital in southern Brazil. METHOD: A qualitative approach was used. Approval was obtained from CEPAS and endorsed by: 63/09. Data was collected via interviews composed of open questions and administered by an eleven member committee. Data analysis and interrelation were achieved by organizing and extracting meaning from the research data. This material lead to the chapter “Member Experience in an Intra-Hospital Commission for Organ and Tissue Donation for Transplantation (CIHDOTT)” with the following categories: Staff inclusion in the implementation of CIHDOTT; Entrance into CIHDOTT; Staff comments about their participation in CIHDOTT; Factors favoring teamwork; Factors hindering teamwork; Strategies used by CIHDOTT in the donation-transplantation process at UH; Contributions to the proper functioning of the commission; Ethical issues related to the execution of staff functions. Thus, this study provides insight and reflection on the practices and experiences of health staff in CIHDOTT. Most staff appeared to be committed, engaged and contributed favorably to the pursuit of better donation results, particularly regarding the interaction between the healthcare team, families of potential donors and the general population. Believing and acting compassionately and ethically and respecting family decisions about organ donation are essential and lead to positive experiences for both the healthcare team and family members. / La actuación de una Comisión Intrahospitalaria de Donación de Órganos y Tejidos para Trasplante (CIHDOTT) permite efectividad en el proceso de captación y donación de órganos, también se hace necesario para facilitar las actividades de identificación de posibles donadores, implementar protocolos, exámenes diagnósticos, comprobar la existencia de muerte encefálica (ME) y notificarla, así como para sensibilizar la familia y reducir posibles obstáculos a la realización de trasplantes en Brasil. OBJETIVO: Conocer la vivencia de la CIHDOTT de una institución hospitalaria del extremo sur de Brasil. MÉTODO: se utilizó un abordaje cualitativo. Se obtuvo la aprobación del CEPAS, de acuerdo con el documento 63/09. La reunión de datos fue hecha con 11 (once) miembros de una comisión por medio de entrevista compuesta por preguntas abiertas. El análisis y la interrelación de los datos fueron realizados a partir de una organización y una extracción de su significado en la investigación, lo que resultó en el capítulo llamado La vivencia como integrante de una Comisión Intrahospitalaria de Donación de Órganos y Tejidos para Trasplantes(CIHDOTT) y de este capítulo surgieron las siguientes categorías: Inserción de los trabajadores en la implantación e implementación de la CIHDOTT; El ingreso en la CIHDOTT; Significados atribuidos por los trabajadores acerca de su participación en la CIHDOTT; Factores que ayudan el trabajo del equipo; Factores que dificultan el trabajo del equipo; Estrategias utilizadas por la CIHDOTT en el proceso de donación y trasplante en el hospital universitario; Contribuciones del adecuado funcionamiento de la comisión; Cuestiones éticas presentes en el desempeño de las actividades de los trabajadores. De esta manera, la pesquisa posibilitó no solamente conocer, pero también reflexionar acerca de las prácticas del equipo de salud y sus vivencias en la CIHDOTT. La mayoría de sus miembros se mostró comprometida y dedicada a la búsqueda de mejores resultados de donaciones, lo que contribuye de manera favorable al proceso, especialmente en relación a la interacción entre equipo de salud, familias de potenciales donadores y población. Acreditar y agir con actitudes éticas y solidarias en el proceso de trasplante y donación, comprender y respetar la autonomía de las familias en decidir acerca de la donación es fundamental para un proceso de captación tranquilo y para que sea una experiencia positiva tanto para el equipo de salud como para los familiares.

Dissertação(mestrado) - Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2011. / Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2013-01-02T17:49:32Z No. of bitstreams: 1 josianecapellaro.pdf: 2197624 bytes, checksum: 0c9a5e0d0181267847c20b2f3106eef7 (MD5) / Approved for entry into archive by Bruna Vieira(bruninha_vieira@ibest.com.br) on 2013-01-04T18:02:39Z (GMT) No. of bitstreams: 1 josianecapellaro.pdf: 2197624 bytes, checksum: 0c9a5e0d0181267847c20b2f3106eef7 (MD5) / Made available in DSpace on 2013-01-04T18:02:39Z (GMT). No. of bitstreams: 1 josianecapellaro.pdf: 2197624 bytes, checksum: 0c9a5e0d0181267847c20b2f3106eef7 (MD5) Previous issue date: 2011 / A atuação de uma Comissão Intra-Hospitalar de Doação de Órgãos e Tecidos para Transplante (CIHDOTT) possibilita o efetivo processo de captação e doação de órgãos, faz-se necessário tanto para favorecer as atividades de identificação de possíveis doadores, implementar protocolos, testes diagnósticos, comprovar a existência de morte encefálica (ME) e notificá-la, quanto para sensibilizar a família, reduzindo possíveis obstáculos à efetivação de transplantes no Brasil. OBJETIVO: Conhecer a vivência da CIHDOTT de uma instituição hospitalar do extremo sul do Brasil. MÉTODO: Utilizou-se uma abordagem qualitativa. Obteve-se a aprovação do CEPAS, mediante o Parecer: 63/09. A coleta de dados foi realizada com 11 (onze) membros de uma comissão através de entrevista composta por questões abertas. A análise e a inter-relação dos dados foram realizadas a partir da organização e da extração do seu significado na pesquisa, emergindo o capítulo denominado A vivência como Integrante de uma Comissão Intra-Hospitalar de Doação de Órgãos e Tecidos para Transplante (CIHDOTT), do qual emergiram as seguintes categorias: Inserção dos trabalhadores na implantação e implementação da CIHDOTT; O ingresso na CIHDOTT; Significados atribuídos pelos trabalhadores acerca de sua participação na CIHDOTT; Fatores que favoreceram o trabalho da equipe; Fatores que dificultaram o trabalho da equipe; Estratégias utilizadas pela CIHDOTT no processo de doação transplante no HU; Contribuições do adequado funcionamento da comissão; Questões éticas presentes no desempenho das atividades dos trabalhadores. Assim, esta pesquisa proporcionou, além de conhecer, também, refletir sobre as práticas da equipe de saúde e suas vivências na CIHDOTT. A maioria dos seus integrantes mostra-se comprometida e engajada na busca de melhores resultados de doações, contribuindo de modo favorável no processo, especialmente com relação à interação entre equipe de saúde, famílias de potenciais doadores e população. Acreditar e agir com atitudes éticas e solidárias no processo de transplante e doação; compreender e respeitar a autonomia das famílias em decidir sobre a doação, torna-se fundamental para um processo de captação tranqüilo, para que haja uma experiência positiva tanto para a equipe de saúde como para os familiares. / The Intra-Hospital Commission for Organ and Tissue Donation for Transplantation (CIHDOTT) enables effective organ acquisition and processing which is necessary not only to help identify potential donors, implement protocols, run diagnostic tests, verify brain death (BD), but also to educate families and thus reduce potential obstacles to transplantation in Brazil. OBJECTIVE: To learn about the experiences of CIHDOTT at a hospital in southern Brazil. METHOD: A qualitative approach was used. Approval was obtained from CEPAS and endorsed by: 63/09. Data was collected via interviews composed of open questions and administered by an eleven member committee. Data analysis and interrelation were achieved by organizing and extracting meaning from the research data. This material lead to the chapter “Member Experience in an Intra-Hospital Commission for Organ and Tissue Donation for Transplantation (CIHDOTT)” with the following categories: Staff inclusion in the implementation of CIHDOTT; Entrance into CIHDOTT; Staff comments about their participation in CIHDOTT; Factors favoring teamwork; Factors hindering teamwork; Strategies used by CIHDOTT in the donation-transplantation process at UH; Contributions to the proper functioning of the commission; Ethical issues related to the execution of staff functions. Thus, this study provides insight and reflection on the practices and experiences of health staff in CIHDOTT. Most staff appeared to be committed, engaged and contributed favorably to the pursuit of better donation results, particularly regarding the interaction between the healthcare team, families of potential donors and the general population. Believing and acting compassionately and ethically and respecting family decisions about organ donation are essential and lead to positive experiences for both the healthcare team and family members. / La actuación de una Comisión Intrahospitalaria de Donación de Órganos y Tejidos para Trasplante (CIHDOTT) permite efectividad en el proceso de captación y donación de órganos, también se hace necesario para facilitar las actividades de identificación de posibles donadores, implementar protocolos, exámenes diagnósticos, comprobar la existencia de muerte encefálica (ME) y notificarla, así como para sensibilizar la familia y reducir posibles obstáculos a la realización de trasplantes en Brasil. OBJETIVO: Conocer la vivencia de la CIHDOTT de una institución hospitalaria del extremo sur de Brasil. MÉTODO: se utilizó un abordaje cualitativo. Se obtuvo la aprobación del CEPAS, de acuerdo con el documento 63/09. La reunión de datos fue hecha con 11 (once) miembros de una comisión por medio de entrevista compuesta por preguntas abiertas. El análisis y la interrelación de los datos fueron realizados a partir de una organización y una extracción de su significado en la investigación, lo que resultó en el capítulo llamado La vivencia como integrante de una Comisión Intrahospitalaria de Donación de Órganos y Tejidos para Trasplantes (CIHDOTT) y de este capítulo surgieron las siguientes categorías: Inserción de los trabajadores en la implantación e implementación de la CIHDOTT; El ingreso en la CIHDOTT; Significados atribuidos por los trabajadores acerca de su participación en la CIHDOTT; Factores que ayudan el trabajo del equipo; Factores que dificultan el trabajo del equipo; Estrategias utilizadas por la CIHDOTT en el proceso de donación y trasplante en el hospital universitario; Contribuciones del adecuado funcionamiento de la comisión; Cuestiones éticas presentes en el desempeño de las actividades de los trabajadores. De esta manera, la pesquisa posibilitó no solamente conocer, pero también reflexionar acerca de las prácticas del equipo de salud y sus vivencias en la CIHDOTT. La mayoría de sus miembros se mostró comprometida y dedicada a la búsqueda de mejores resultados de donaciones, lo que contribuye de manera favorable al proceso, especialmente en relación a la interacción entre equipo de salud, familias de potenciales donadores y población. Acreditar y agir con actitudes éticas y solidarias en el proceso de trasplante y donación, comprender y respetar la autonomía de las familias en decidir acerca de la donación es fundamental para un proceso de captación tranquilo y para que sea una experiencia positiva tanto para el equipo de salud como para los familiares.

Background: The demand for organ donation is increasing but there is always a lack of organ donor supply. To receive an organ donation, specific criteria must be met. Matching criteria between the donor and the recipient is critically important. The likelihood of having a capable organ increases when the donors and recipients have the same ethnicity. However, the number of organ donors differ significantly based on ethnicity. Purpose: The purpose of this literature review was to explore the impact of cultural background and education among the Asian and non-Hispanic White population on organ donation and how it impacts individuals' decisions on becoming organ donators. Methods: To explore the impact of cultural background and education on the Asian and non-Hispanic White population regarding organ donation, a literature review was conducted. The databases including, CINAHL Plus with Full Text and MEDLINE were utilized. Google Scholar was used for additional articles related to the topic. The time frame of the articles was from January 2012 to January 2022, a ten-year frame. Results: Overall, the Asian population had a lower deceased organ donation rate and registration rate in comparison to the non-Hispanic White population. The factors that contributed to low organ donation and registration include traditional religion, lack of knowledge, miscommunication, mistrust in the healthcare system, and consideration of family members' attitudes. Conclusion: Organ donation and registration rates remain low in the Asian population in comparison to the non-Hispanic White population due to several barriers related to their cultural background. Thus, it is critical to educate the patients and their family members regarding organ donation to increase the organ donation and registration rate.

No período de 1981-2010, foram estudados, retrospectivamente, 54 casos de criptococose em pacientes com transplante de órgão sólido, identificados no Laboratório de Micologia da Santa Casa Complexo Hospitalar, Porto Alegre, RS. A criptococose ocorreu em 31 transplantados de rim, 13 de fígado, 7 de pulmão, 2 de pâncreas e rim, e 1 de coração. A idade média foi de 47,91 ± 13,98 (12-76 anos). Um total de 38 pacientes do sexo masculino (70,4%). As manifestações clínicas mais frequentes (54 pacientes) foram febre, cefaléia, vômito, tosse e estado mental alterado. Os achados radiográficos mais comuns no tórax, em 27 pacientes, foram nódulo, consolidação, cavitação e derrame pleural, sendo 10 com comprometimento pulmonar comprovado. Trinta e quatro apresentavam acometimento do sistema nervoso central, 7 tinham envolvimento cutâneo, e 4 em outros locais. O liquor, sangue e urina, respectivamente, contribuíram para o diagnóstico microbiológico com maior frequência. A maioria das infecções, nesta série de pacientes com criptococose, foi causada por Cryptococcus neoformans (92,7%). Pela primeira vez na literatura, documentamos C. gattii em pacientes com transplante de pulmão. Finalmente, quanto ao regime imunossupressor primário utilizado, houve maior mortalidade entre os pacientes que usaram o regime terapêutico baseado em ciclosporina e menor naqueles que usaram tacrolimus. / In the period of 1981 to 2010, 54 cases of cryptococcosis in patients with solid organ transplantation indetified at Mycology Laboratory in Santa Casa Hospital Complex, Porto Alegre, RS, were retrospectively studied. Cryptococcois occured in 31 kidney, 13 liver, 7 lung, 2 kidney-pancreas, and 1 heart transplant. The mean age was 47.3 years old (range, 12-76; SD 13.98). A total of 38 patients were male (70.4%). The most frequent clinical manifestation (54 patients) was fever, headache, vomiting, cough and altered mental status. The most common chest radiographic fidings, in 27 patients, were nodules, masses, consolidation, cavitation, and pleural effusion, 10 with proved pulmonary involvement. Thirty four patients had central nervous system involvement, 7 with cutaneous involvement, and 4 at other sites. The cerebospinal fluid, blood, and urine had the highest yield for the microbiologic diagnosis, respectivelly. Nearly all infections in this series of patients with cryptococcosis involved Cryptococcus neoformans (92.7%). By the first time in the literature, we documented C. gattii in lung transplant patients. Finally, considering the type of primary immunosupressive agent used, there was a higher mortality rate on patients with cyclosporine based therapy, and lowest in those with tacrolimus.

No período de 1981-2010, foram estudados, retrospectivamente, 54 casos de criptococose em pacientes com transplante de órgão sólido, identificados no Laboratório de Micologia da Santa Casa Complexo Hospitalar, Porto Alegre, RS. A criptococose ocorreu em 31 transplantados de rim, 13 de fígado, 7 de pulmão, 2 de pâncreas e rim, e 1 de coração. A idade média foi de 47,91 ± 13,98 (12-76 anos). Um total de 38 pacientes do sexo masculino (70,4%). As manifestações clínicas mais frequentes (54 pacientes) foram febre, cefaléia, vômito, tosse e estado mental alterado. Os achados radiográficos mais comuns no tórax, em 27 pacientes, foram nódulo, consolidação, cavitação e derrame pleural, sendo 10 com comprometimento pulmonar comprovado. Trinta e quatro apresentavam acometimento do sistema nervoso central, 7 tinham envolvimento cutâneo, e 4 em outros locais. O liquor, sangue e urina, respectivamente, contribuíram para o diagnóstico microbiológico com maior frequência. A maioria das infecções, nesta série de pacientes com criptococose, foi causada por Cryptococcus neoformans (92,7%). Pela primeira vez na literatura, documentamos C. gattii em pacientes com transplante de pulmão. Finalmente, quanto ao regime imunossupressor primário utilizado, houve maior mortalidade entre os pacientes que usaram o regime terapêutico baseado em ciclosporina e menor naqueles que usaram tacrolimus. / In the period of 1981 to 2010, 54 cases of cryptococcosis in patients with solid organ transplantation indetified at Mycology Laboratory in Santa Casa Hospital Complex, Porto Alegre, RS, were retrospectively studied. Cryptococcois occured in 31 kidney, 13 liver, 7 lung, 2 kidney-pancreas, and 1 heart transplant. The mean age was 47.3 years old (range, 12-76; SD 13.98). A total of 38 patients were male (70.4%). The most frequent clinical manifestation (54 patients) was fever, headache, vomiting, cough and altered mental status. The most common chest radiographic fidings, in 27 patients, were nodules, masses, consolidation, cavitation, and pleural effusion, 10 with proved pulmonary involvement. Thirty four patients had central nervous system involvement, 7 with cutaneous involvement, and 4 at other sites. The cerebospinal fluid, blood, and urine had the highest yield for the microbiologic diagnosis, respectivelly. Nearly all infections in this series of patients with cryptococcosis involved Cryptococcus neoformans (92.7%). By the first time in the literature, we documented C. gattii in lung transplant patients. Finally, considering the type of primary immunosupressive agent used, there was a higher mortality rate on patients with cyclosporine based therapy, and lowest in those with tacrolimus.

The diploma thesis deals with the issues of nursing care and the nurse?s position in the complex process of transplantation. Transplantation treatment becomes more important in the course of time. There are such situations that there is no other choice of restoring and saving the health of the sick person but to transplant. The complex process of transplantation is a chain of successive operations in which not only many doctors but also other medical and paramedical staff are involved and they constantly interact not only with the patient. Classically, the largest group in providing patient care is general nurses who assume the responsibility for the direct provision of nursing care, work independently and are responsible for the care provided. Their work requires a deep knowledge of the branch and many professional activities without suppressing their original mission. Today?s nurse is a full member of the team and the doctor?s partner in practicing his or her profession. The theoretical part deals comprehensively with the issues of the removal of organs especially from deceased donors, their transplantation and legislation in the Czech Republic and especially with the role of a nurse which she has in this process. An objective of the research survey was to map whether a nurse really felt to be the doctor?s partner in this challenging branch of providing nursing care and what their attitudes towards practicing their own profession in this branch were and to map the extensiveness of their knowledge and educational opportunities in these issues. Another objective was to map the attitudes of patients themselves towards care in the transplantation treatment process. In the research survey a quantitative method was used and applied by distributing questionnaires to general nurses working at a department of transplantation medicine. The results of the questionnaire survey were processed to create well-arranged tables. The qualitative part of the research survey was carried out through interviews with patients who are in the transplantation treatment process. The interviews were processed in writing and the results were summarized in mind maps.

No período de 1981-2010, foram estudados, retrospectivamente, 54 casos de criptococose em pacientes com transplante de órgão sólido, identificados no Laboratório de Micologia da Santa Casa Complexo Hospitalar, Porto Alegre, RS. A criptococose ocorreu em 31 transplantados de rim, 13 de fígado, 7 de pulmão, 2 de pâncreas e rim, e 1 de coração. A idade média foi de 47,91 ± 13,98 (12-76 anos). Um total de 38 pacientes do sexo masculino (70,4%). As manifestações clínicas mais frequentes (54 pacientes) foram febre, cefaléia, vômito, tosse e estado mental alterado. Os achados radiográficos mais comuns no tórax, em 27 pacientes, foram nódulo, consolidação, cavitação e derrame pleural, sendo 10 com comprometimento pulmonar comprovado. Trinta e quatro apresentavam acometimento do sistema nervoso central, 7 tinham envolvimento cutâneo, e 4 em outros locais. O liquor, sangue e urina, respectivamente, contribuíram para o diagnóstico microbiológico com maior frequência. A maioria das infecções, nesta série de pacientes com criptococose, foi causada por Cryptococcus neoformans (92,7%). Pela primeira vez na literatura, documentamos C. gattii em pacientes com transplante de pulmão. Finalmente, quanto ao regime imunossupressor primário utilizado, houve maior mortalidade entre os pacientes que usaram o regime terapêutico baseado em ciclosporina e menor naqueles que usaram tacrolimus. / In the period of 1981 to 2010, 54 cases of cryptococcosis in patients with solid organ transplantation indetified at Mycology Laboratory in Santa Casa Hospital Complex, Porto Alegre, RS, were retrospectively studied. Cryptococcois occured in 31 kidney, 13 liver, 7 lung, 2 kidney-pancreas, and 1 heart transplant. The mean age was 47.3 years old (range, 12-76; SD 13.98). A total of 38 patients were male (70.4%). The most frequent clinical manifestation (54 patients) was fever, headache, vomiting, cough and altered mental status. The most common chest radiographic fidings, in 27 patients, were nodules, masses, consolidation, cavitation, and pleural effusion, 10 with proved pulmonary involvement. Thirty four patients had central nervous system involvement, 7 with cutaneous involvement, and 4 at other sites. The cerebospinal fluid, blood, and urine had the highest yield for the microbiologic diagnosis, respectivelly. Nearly all infections in this series of patients with cryptococcosis involved Cryptococcus neoformans (92.7%). By the first time in the literature, we documented C. gattii in lung transplant patients. Finally, considering the type of primary immunosupressive agent used, there was a higher mortality rate on patients with cyclosporine based therapy, and lowest in those with tacrolimus.

The concept of organ transplantation is not a new concept in South Africa and many organ transplants are performed annually. However, the problem that arises is that there is currently a shortage of donor organs suitable for transplant and this leads to the demand for organs exceeding the supply thereof. This in itself opens the door for unethical and criminal ways of obtaining organs. One of the ways in which these organs are obtained is child trafficking for the sole purpose of removal of organs. Although there are several reasons why children are abducted and used in child trafficking practices, the removal of their organs is discussed as the main reason in this study. The Protocol to Prevent, Suppress and Punish Trafficking in Persons, especially Women and Children, Supplementing the United National Convention against Transnational Organized Crime (2000) (hereinafter the Protocol), which South Africa signed and ratified, is the international instrument which places an obligation on South Africa to address the issue relating to human trafficking by implementing legislation. Until recently there had been no legislation specifically regulating human trafficking. Through the years, several bills for implementation in the national legislative framework were proposed to parliment. In 2013, the Prevention and Combating of Trafficking in Persons Act was incorporated into national legislation to address South Africa's international and regional obligations. In this study, the international, regional and national framework concerning trafficking is outlined and discussed as well as the Prevention and Combating of Trafficking in Persons Act to determine to what extent they do provide protection to victims of human trafficking. / LLM (Comparative Child Law), North-West University, Potchefstroom Campus, 2015