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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Att ge liv : Donatorns upplevlse av en njurdonation / To give life : The donors experience of a kidney donation

Malmberg, Tova, Sollenius, Emelie January 2020 (has links)
Bakgrund: Det är mer fördelaktigt att en organdonation sker med levande donator istället för avliden donator, då det är lägre risk för avstötning. Det är många som väntar på att få en njure vilket gör att levande donation blir allt vanligare. I Sverige genomfördes 147 levande njurdonationer år 2019. Njurdonation ökar vilket leder till ökat behov av kunskap och förståelse hos sjuksköterskan. Syfte: Syftet var att belysa donatorns upplevelser i samband med njurdonation. Metod: Studien genomfördes via en litteraturstudie, där 12 vetenskapliga artiklar granskades och analyserades från två databaser. Resultat: Resultatet består av tre teman och sju subkategorier. Temat Kommunikation med subkategorierna upplevelsen av kommunikation med vårdpersonal och anknytning till mottagaren, temat upplevda känslor med subkategorierna oro, glädje och hopp, temat upplevelsen av stöd med subkategorierna socialt stöd och ekonomiskt stöd. Slutsatser: Upplevelserna hos donatorerna var individuella, genomgående var upplevelsen av bristande kommunikation och oro. Bristen på kommunikation indikerar till ett ökat kunskapsbehov hos sjuksköterskor för att göra donationsupplevelsen bra. / Background: It is more advantageous that a organdonation to take place with a living donor instead of a deceased donor, as there is a lower risk of rejection. There are many waiting for a new kidney, thus living donations are becoming more frequent. In 2019 there were 147 living kidney donations in Sweden. Because of the increase in kidney donations, the nurses are in need of more knowledge and understanding of the whole procedure. Aim: The aim was to give an account of the donor’s experience throughout the process of donating a kidney. Method: The study was conducted through literary research, where 12 scientific articles from two databases were reviewed and analyzed. Result: The result consists of three themes and seven sub categories; Communication - Communication experience between patients and medical staff andConnection to the recipient, Emotions - Worry, Joy and Hope, Support - Social support and Economical support. Conclusion: The donor’s feelings were varied, but overall they felt a lack of communication and therefore worry. This indicates that the nurses are in need of improved communication skills in order to make the donation experience as good as possible.
2

Kidney Compatibility Score Generation for a Donor - Recipient pair using Fuzzy Logic

Yellanki, Sampath Kumar January 2012 (has links)
No description available.
3

Toppar och dalar efter njurtransplantation : Njurtransplanterade patienters känslor och upplevelser: en litteraturöversikt / Highs and lows after renal transplantation : Kidney transplanted patients emotions and experiences: a literature review

Sandkvist, Adelina, Sörmdal Hellström, Elisa January 2024 (has links)
Bakgrund: Njurtransplantation är det medicinskt bästa behandlingsalternativet vid terminal njursvikt. 'Quality of life’ ökar efter en transplantation men når inte upp till samma nivåer som hos en frisk befolkning. Mottagaren av en njure kan även uppleva ångest och depression. En djupare inblick i vad som orsakar dessa känslor, samt vilka andra känslor en njurtransplanterad patient kan uppleva, är av värde för att sjuksköterskan ska kunna bemöta och stötta dessa individer.  Syfte: Syftet var att beskriva känslor och upplevelser efter att ha genomgått njurtransplantation från en levande eller avliden donator. Metod: En allmän litteraturöversikt baserad på 12 vetenskapliga artiklar, med kvalitativ ansats, publicerade i PubMed eller CINAHL. Samtliga artiklar kvalitetsgranskas med SBU:s mall för kvalitativa studier och analyserades med en induktiv ansats. Resultat: Resultatet i denna litteraturöversikt baseras på 12 kvalitativa originalartiklar utförda i 7 olika länder. Tre huvudkategorier med 7 underkategorier återfanns. Huvudkategorierna var: 1. Den inre resans toppar och dalar, 2. En bergochdalbana av känslor gentemot donatorn, 3. Integrering och isolering i sociala relationer. Arbetet fann att deltagarna upplevde en bred variation av känslor som hopp, frihet, nedstämdhet och rädsla. Det var vanligt förekommande med komplexa känslor gentemot donatorn där både tacksamhet och skuld kunde existera samtidigt. I relation till omgivningen upplevde många avsaknad av stöd, medan andra kände stöd från familj, vänner eller andra njurtransplanterade. Slutsats: Njurtransplanterade patienter kan uppleva en bred variation av känslor. Återkommande utmaningar i livet efter transplantation kan vara förändringar kring ens identitet, rädslor för framtiden, skuld gentemot donatorn och upplevelser av att inte känna sig förstådd av omgivningen. Sjuksköterskan har en viktig roll i att bemöta och stötta dessa patienter. / Background: Kidney transplantation is the best medical treatment option for end-stage renal failure. Quality of life improves after a transplant but does not reach the same levels as in a healthy population. Kidney recipients may also experience anxiety and depression. A deeper understanding of the causes of these emotions, as well as the range of other emotions experienced by kidney transplant patients, is valuable for nurses to be able to address and support these individuals. Aim: The aim was to describe the emotions and experiences following kidney transplantation from a living or deceased donor. Method: A general literature review based on 12 scientific articles, using a qualitative approach, published in PubMed or CINAHL. All articles were assessed for quality using the SBU’s template for qualitative studies and analyzed using an inductive approach. Result: The findings in this literature review are based on 12 qualitative original articles conducted in 7 different countries. Three main categories with 7 subcategories were identified. The main categories were: 1. Highs and lows of the inner journey, 2. A rollercoaster of emotions towards the donor, 3. Integration and isolation in social relationships. The study found that participants experienced a wide range of emotions including hope, freedom, distress, and fear. Complex emotions towards the donor, where both gratitude and guilt could coexist simultaneously, were common. In relation to the surroundings, many experienced a lack of support, while others felt supported by family, friends, or other kidney transplant recipients. Conclusion: Kidney transplant patients may experience a wide range of emotions. Recurring challenges in life after transplantation can include changes in one’s identity, fears for the future, guilt towards the donor, and experiences of not feeling understood by others. The nurse plays a crucial role in acknowledging and supporting these patients.
4

Einflussfaktoren auf die gesundheitsbezogene Lebensqualität und das subjektive physische und psychische Befinden von Spendern und Empfängern nach Lebendnierentransplantation

Lorenz, Friederike 22 April 2021 (has links)
Die Nierentransplantation stellt aktuell die Therapie der Wahl für Patienten mit terminaler chronischer Niereninsuffizienz dar. Dabei ist die Lebendspende der postmortalen Transplantation vorzuziehen, sofern ein passender Organspender zur Verfügung steht. Welchen Stellenwert einzelne Einflussfaktoren und Aspekte für das körperliche und seelische Wohlbefinden einnehmen, soll in dieser Arbeit an den 1997 – 2014 ope- rierten Patienten des Transplantationszentrums Dresden untersucht werden. Zusammenfassend beschäftigt sich diese Studie mit der gesundheitsbezogenen Lebensqualität von Spendern und Empfängern nach einer Lebendnierentransplantation. Die Ergebnisse sollen dazu beitragen, die perioperative Therapie und Betreuung zu optimieren sowie dem persönlichen Umfeld Hinweise zur Unterstützung ihrer Angehörigen aufzuzeigen.:Inhaltsverzeichnis Abbildungs- und Tabellenverzeichnis Abkürzungsverzeichnis 1. Einleitung 1.1 Funktion der Niere 1.2 Die Niereninsuffizienz 1.3 Nierenersatzverfahren 1.4 Organtransplantation 1.5 Das Transplantationsgesetz 1.6 Lebendnierenspende 1.6.1 Modelle 1.6.2 Voraussetzungen 1.6.2.1 Medizinisch 1.6.2.2 Psychologisch 1.6.2.3 Rechtlich 1.6.3 Durchführung 1.6.4 Vorteile 1.6.5 Risiken 1.6.6 Gesundheitsbezogene Lebensqualität und Transplantation 1.6.6.1 Empfänger 1.6.6.2 Spender 1.7 Entscheidungsfindung 2 Material und Methoden 2.1 Ziele und Fragestellungen 2.2 Durchführung der Datenerhebung 2.3 Beschreibung der Instrumente 2.3.1 BSI-18 2.3.2 Morisky-Score 2.3.3 WHO-5 2.3.4 Beratungsbedarf 2.3.5 LOT-R 2.3.6 BFI-K 2.3.7 F-SozU-22 2.3.8 GBB-24 2.3.9 Item Bundesgesundheitssurvey 2.4 Datenaufbereitung und statistische Auswertung 3 Ergebnisse 3.1 Auswertung nach Spenderstatus 3.1.1 Soziodemographie 3.1.2 Komplikationen 3.1.3 Zufriedenheit 3.1.4 Veränderungen 3.1.5 Psychisches Befinden 3.1.6 Compliance 3.1.7 Lebensqualität 3.1.8 Beratungsbedarf 3.1.9 Persönlichkeit 3.1.10 Soziale Unterstützung 3.1.11 Körperliche Beschwerden 3.2 Auswertung nach Geschlecht 3.2.1 Soziodemographie 3.2.2 Komplikationen 3.2.3 Zufriedenheit 3.2.4 Veränderungen 3.2.5 Psychisches Befinden 3.2.6 Compliance 3.2.7 Lebensqualität 3.2.8 Beratungsbedarf 3.2.9 Persönlichkeit 3.2.10 Soziale Unterstützung 3.2.11 Körperliche Beschwerden 3.3 Auswertung nach Alter 3.3.1 Komplikationen 3.3.2 Zufriedenheit 3.3.3 Veränderungen 3.3.4 Psychisches Befinden 3.3.5 Compliance 3.3.6 Lebensqualität 3.3.7 Beratungsbedarf 3.3.8 Persönlichkeit 3.3.9 Soziale Unterstützung 3.3.10 Körperliche Beschwerden 3.4 Auswertung nach Bildungsstand 3.4.1 Soziodemographie 3.4.2 Komplikationen 3.4.3 Zufriedenheit 3.4.4 Veränderungen 3.4.5 Psychisches Befinden 3.4.6 Compliance 3.4.7 Lebensqualität 3.4.8 Beratungsbedarf 3.4.9 Persönlichkeit 3.4.10 Soziale Unterstützung 3.4.11 Körperliche Beschwerden 3.5 Auswertung nach postoperativem Zeitraum 3.5.1 Komplikationen 3.5.2 Zufriedenheit 3.5.3 Veränderungen 3.5.4 Psychisches Befinden 3.5.5 Compliance 3.5.6 Lebensqualität 3.5.7 Beratungsbedarf 3.5.8 Persönlichkeit 3.5.9 Soziale Unterstützung 3.5.10 Körperliche Beschwerden 3.6 Regressionsanalyse 3.6.1 Zusammenhänge psychische Belastung 3.6.2 Zusammenhänge körperliches Befinden/Beschwerdedruck 3.6.3 Zusammenhänge Lebensqualität 3.6.4 Zusammenhänge soziale Unterstützung 3.6.5 Zusammenhänge Zufriedenheit 3.7 Korrelationsanalyse 4 Diskussion der Studie 4.1 Spender und Empfänger 4.2 Frauen und Männer 4.3 Alter 4.4 Bildungsstand 4.5 Datum der Transplantation 4.6 Studienkritik 4.6.1 Auswahl der Patienten 4.6.2 Durchführung 4.6.3 Auswertung 5 Zusammenfassung 6 Literaturverzeichnis 7 Anhang 7.1 Tabellen 7.2 Fragebogen 7.3 Fragebogen „Nachbefragung“ 7.4 Votum der Ethikkommission 7.5 Anlage 1 7.6 Anlage 2 8 Danksagung
5

Doação renal: experiências de pessoas doadoras à luz da psicologia fenomenológica-existencial

Magalhães, Luana de Carvalho 23 May 2013 (has links)
Made available in DSpace on 2016-04-28T20:38:41Z (GMT). No. of bitstreams: 1 Luana de Carvalho Magalhaes.pdf: 2878758 bytes, checksum: 5cabbd769a7ce8774663f925f71aa031 (MD5) Previous issue date: 2013-05-23 / With the great achievements of biotechnology, there has been an increase in the number of kidney transplantations with live donors in Brazil. In the past decade, several studies focused in quantifying, analysing and describing the aspects of live kidney donation. Due to its complexity, it has conflicts in psychic, social, spiritual and existential aspects. The present study aims to describe the fantastic world of donors with the choice of donating a kidney and understand the possible choices of those who have performed the transplant. Meaning to describe the life of each donor, this is a phenomenologic qualitative research with an interview with six kidney donor adults living in São Paulo. The interviews were performed by questions followed by a trigger question considering the participant s answer and following its phenomenologic flow. For data analysis and synthesis, the following steps were put into practice: description, reduction and phenomenon interpretation. The lack of a psychological work on the donors was noticed before, during and after donation. Finally, this essay reveals being a kidney donor has new challenges and confrontations to save the life of a family member, in addition to the subjective aspects in the choices and decisions of being a donor / Com o grande avanço da biotecnologia foi possível observar um crescente número de transplantes renais com doadores vivos no Brasil. Na última década, muitos estudos têm se preocupado em quantificar, analisar e descrever os aspectos do fenômeno da doação renal intervivos. Por sua complexidade, envolve conflitos nas suas dimensões psíquicas, sociais, espirituais e existenciais. Este estudo teve como objetivo descrever o que aconteceu no mundo fenomenal de pessoas doadoras com a escolha de doar um rim e apreender as possibilidades de escolhas dessas pessoas que realizaram o transplante. Com a intenção de descrever a vivência interna de cada doador, foi realizada uma pesquisa qualitativa de abordagem fenomenológica entrevistando seis participantes adultos que realizaram a doação renal na cidade de São Paulo. Foram realizadas entrevistas através da construção de perguntas seguidas à pergunta disparadora, a partir do discurso do doador participante, seguindo o seu fluxo de sentido fenomenológico. Para a análise e síntese dos dados, seguiu-se as seguintes etapas: descrição, redução e interpretação fenomenológica. Apurou-se a insuficiência do trabalho psicológico realizado com os doadores, que deve abranger as fases pré, durante e pós doação. Por fim, o presente estudo revelou que a experiência de ser um doador renal apresenta novos desafios e enfrentamentos em prol do desejo de salvar a vida de um familiar enfermo e ainda reflete aspectos subjetivos que permeiam nas escolhas e decisões de ser doador renal
6

Njurdonatorers upplevelser av att frivilligt donera en njure / Experiences of kidney donors voluntarily donating a kidney.

Olsson, Kriss, Almaou, Alaa January 2024 (has links)
Bakgrund: Njurdonation är en omfattande process där en individ, efter eget beslut eller i samråd med andra, donerar en av sina friska njurar till en mottagare i behov av den för att förbättra sin överlevnad och hälsa. Som grundutbildad sjuksköterska har man tillgång till flera olika arbetsplatser, vilket innebär att man kommer möta olika patientgrupper i sitt yrke. I omvårdnaden av en njurdonator är den personcentrerade vården en viktig grundsten. Utöver denna princip är sjuksköterskans övriga kärnkompetenser avgörande. Det är nödvändigt att kunna samarbeta i team eftersom patienten inte bara behöver sjuksköterskans stöd utan även hjälp och kontakt med andra vårdpersonal såsom läkare, specialistsjuksköterska samt psykolog och kurator. Den grundutbildade sjuksköterskan spelar rollen som navet i samarbetet, med ansvar för att säkerställa att all samverkan fungerar samtidigt och ingen aspekt av vården försummas. Därför är det av vikt att den grundutbildade sjuksköterskan har kunskap om njurdonatorers upplevelser både pre- och postoperativt. Syfte: litteraturstudiens syfte var att belysa pre- och postoperativa donationsupplevelse för donatorer som frivilligt donerar en njure. Metod: Studien genomfördes som en systematisk litteraturgenomgång med en kvalitativ metod på en grund av tio vetenskapliga peer-reviewed artiklar. Analysen av artiklarna följde en specifik modell för innehållsanalys. Resultat: Tre huvudkategorier definierar donatorernas upplevelser av den pre-och postoperativa donationsprocessen; ”Donatorernas anledningar till att donera”, ”Betydelsefullt med emotionellt stöd och förståelse” och ”Stress och komplikationer”. Konklusion: Njurdonatorers erfarenheter är övervägande positiva men präglas av intensiva känslor såsom glädje och stolthet, samtidigt som de upplever nervositet och stress inför godkännandet som donator. Tillräckligt stöd och förståelse från vårdpersonal och närstående underlättar hanteringen av den emotionella påfrestningen. För sjuksköterskor är insikten om donatorers upplevelser avgörande för att erbjuda personcentrerad vård och förbereda både vårdpersonal och donator för potentiella konsekvenser, vilket främjar högre vård- och livskvalitet för donatorn. Nyckelord: Grundutbildad sjuksköterska, Njurdonation, Njurtransplantation, upplevelser, Personcentrerad vård / Background: Kidney donation is a medical process where an individual, by their own decision or in consultation with others, donates one of their healthy kidneys to a recipient in need, aiming to improve their survival and health. As a registered nurse, one has access to various workplaces and opportunities, meaning they will encounter different types of patients in their profession. In the care of kidney donors, person-centered care stands as a crucial cornerstone. Beyond this principle, the nurse´s other core competencies are paramount. Collaborating within a team is essential since the patient requires not only the nurse´s support but also assistance and interaction with other healthcare professionals such as physicians, specialized nurses, psychologists, and counselors. The bachelor's degree nurse plays a pivotal role in this collaboration, being responsible for ensuring seamless cooperation while no aspect of care is neglected. Therefore, it is crucial for the bachelor's degree nurse to have knowledge of kidney donors´experiences both pre- and post-operatively. Aim: The aim of the literature study was to illustrate the pre-and postoperative donation experience of donors who voluntarily donate a kidney. Method: The research was conducted as an approach to a qualitative systematic literature review, drawing from ten peer-reviewed original articles. The Articles underwent analysis following a specific model for content analysis. Result: Three main categories define the donors' experiences of the pre- and post-operative donation process; “Donors’ reasons for donating”, “Meaningful with emotional support and understanding” and “Stress and complications”. Conclusion: Kidney donors` experiences are predominantly positive but are characterized by intense emotions such as joy and pride, while at the same time they experience nervousness and stress before being accepted as a donor. Sufficient support and understanding from healthcare staff and relatives facilitates the handling of the emotional strain. For nurses, the insight into donors´experiences is essential to provide person-centered care and prepare both health care professionals and donors for potential consequences, promoting higher quality of care and quality of life for the donor. Keywords: Registered nurse, experiences. kidney donation, kidney transplantation, person-centred care.
7

Kidney conditions associated with hypertension in pregnancy

Nevis, Franklin Preethi Immaculate January 2013 (has links)
<p>We defined hypertension in pregnancy as a composite of gestational hypertension, preeclampsia and eclampsia. The etiology of hypertension in pregnancy remains controversial. The three chapters of this thesis explore the risk of hypertension in pregnancy from various kidney conditions. Chapter 1 introduces the reader to the thesis. Chapter 2 is a systematic review that studied the risk of developing hypertension in pregnant women with chronic kidney disease but not on dialysis. We found that women with chronic kidney disease had at least a twofold higher relative risk of developing hypertension during pregnancy compared with women having no chronic kidney disease. Chapter 3 is a retrospective study looking at the risk of developing gestational hypertension and preeclampsia in women who had symptomatic gastroenteritis after drinking water infected with <em>E. coli</em> O157:H7 during the Walkerton outbreak in May 2000. We conducted this study using linked datasets at the Institute of Evaluative Sciences (ICES) Toronto, Ontario. We observed that there was no increased risk of developing gestational hypertension or preeclampsia among the symptomatic women compared with women from the neighbouring towns who were asymptomatic or did not drink the water. Chapter 4 is a protocol of a prospective cohort study recruiting female kidney donors and healthy non-donors as the comparative group to study pregnancy outcomes in these individuals. This is a multicentre study involving 12 transplant centres throughout Canada. There are 59 participants in this study to date (Feb 28, 2013) of which seven have been pregnant so far. Data collection for this study is ongoing.</p> / Doctor of Philosophy (PhD)
8

Perceptions of the relatives of patients suffering from chronic renal failure regarding kidney donation

Mbeje, Nthombithini Pretty 06 1900 (has links)
1 electroninc resource (ix, 86 leaves) / This study aimed at exploring and describing the perceptions of relatives of patients with chronic renal failure regarding kidney donation. The number of patients suffering from chronic renal failure awaiting kidney transplantation is on the increase, while the treatment they get in the interim is not cost effective. The researcher used qualitative descriptive and exploratory research using the Potter and Perry’s Health Belief Model. She applied purposive sampling and used semi structured interviews to collect data from 45 participants who were all relatives of patients coming for haemodialysis at a selected hospital in KwaZulu-Natal. Data analysis identified participants’ perceptions regarding chronic renal failure and kidney donation. Findings of the study revealed that most relatives were fully aware of kidney donation, but fear and lack of knowledge regarding kidney transplantation were the main barriers to them offering themselves for kidney donation. The researcher recommends that the Renal Transplant Multidisciplinary Committee should ensure the public is informed about kidney donation and more intensive education should be given to the relatives of patients suffering from chronic renal failure at an early stage in the illness to give them more time to come to terms with the concept of kidney donation. / Health Studies / M.A. (Health Studies)
9

Aktuelle Programme zur Weiterentwicklung der Nierentransplantation

Giessing, Markus Maria 08 February 2005 (has links)
Trotz Inkrafttretens des ersten gesamtdeutschen Transplantationsgesetzes im Dezember 1997 steigt die Anzahl terminal niereninsuffizienter Patienten auf der Warteliste, ebenso wie die Wartezeit auf eine Nierentransplantation (NTX). Verschiedene Programme existieren, um der Organknappheit zu begegnen. Im Eurotransplant Senior Programm (ESP) werden seit 1999 Nieren älterer verstorbener Spender (65+) an ältere Empfänger (65+) unabhängig von der Gewebeübereinstimmung auf lokaler Ebene übertragen. Unsere Studien konnten zeigen, dass die Transplantat- und Empfängerüberlebensraten sich nicht von denen nach Transplantation jüngerer Spendernieren in alte Empfänger unterscheiden. Transplantatverlust im ESP tritt meist als Tod mit funktionierendem Transplantat auf. Dies ist die Folge vermehrt vorkommender Komorbiditäten in dieser Empfängergruppe und unterstreicht die Notwendigkeit einer intensiven prä-operativen Evaluation sowie engmaschigen Nachsorge. Zudem konnten wir zeigen, dass die Grundannahme einer verminderten Immunkompetenz älterer Empfänger nicht zutrifft. Eine Änderung der Allokationsregeln von Eurotransplant wird deshalb diskutiert, die auch im ESP die Gewebetypisierung berücksichtigt. Der Anteil der Lebendnierenspende (LNTX) in Deutschland hat sich in den vergangenen Jahren auf ca. 19% verdreifacht. An unserer Klinik macht sie ca. 30% der durchgeführten NTX aus. Zudem wird an unserer Klinik deutschlandweit die laparoskopische Spendernierenentnahme am häufigsten durchgeführt. Folge einer hier durchgeführten prospektiven Studie zur präoperativen Bildgebung der renalen Gefäßarchitektur des Spenders ist der Verzicht auf invasive Methoden. In weiteren Untersuchungen konnten wir zeigen, dass die Akzeptanz von Lebendspendern mit erweiterten Spenderkriterien gute Möglichkeiten bieten NTX-Programme zu intensivieren. In einer Lebensqualitätsstudie untersuchten wir erstmalig für den deutschen Sprachraum die postoperativen Verläufe von Lebendnierenspendern und konnten neben einer grundsätzlichen Zufriedenheit auch besondere Bedürfnisse aufdecken. Verschiedene Studien zur Laparoskopie in der LNTX, Handhabung und Optimierung dieses neuen Verfahrens sowie dessen Anwendbarkeit bei anatomischen Besonderheiten konnten zeigen, dass diese Methode ein sicheres Verfahren darstellt. Anhand unserer Erfahrungen in der LNTX haben wir zudem Empfehlungen zur Evaluation und Nachbetreuung von Lebendnierenspendern erarbeitet. Insgesamt sind das ESP und die LNTX, hier besonders die laparoskopische Spendernierenentnahme, effektive Konzepte zur Erweiterung der Nierentransplantationsprogramme. / Despite the implementation of a transplantation law in 1997 the number of patients with end-stage renal disease in Germany is rising, as is the waiting time for a kidney transplantation (KTX). Different programs exist to counterbalance organ shortage. The Eurotransplant Senior Programm (ESP), initiated in 1999, allocates kidneys of deceased donors aged 65 and older (65+) irrespective of tissue matching locally to recipients 65+. Our studies revealed that graft- and patient survival in this program are comparable to that after transplantation of young donor-kidneys in old recipients. Graft loss is mostly due to recipient death, which is a consequence of the co-morbidities of the recipient. Meticulous evaluation and intensified follow-up in this recipient-group are most important. Furthermore, despite the assumption of a reduced immunologic response of old recipients we could show that they are very well immunocompetent. Therefore, a change in allocation rules at Eurotransplant is discussed, possibly involving HLA-matches in the ESP. Living donor kidney transplantation (LDKTX) has increased three-fold over the last years and features about 19% of all hat KTX in Germany. In our department LDKTX features about 30% of all KTX and our department also performs the most laparoscopic explantations of living kidney donors in Germany. With regard to the preoperative donor evaluation we could show in a prospective study that non-invasive methods for renal vessel imaging are better than the standard invasive approach. Further research proved that applying extended donor criteria renders good results for graft and recipient and thus is a viable option to increase LDKTX. In the first German study on donors Quality of Life we mostly found satisfied donors and also could detect specific donor demands. For the laparoscopic approach we performed different studies on the technique, its improvement and peculiarities, proving that laparoscopic organ retrieval is a safe method in LDKTX. ESP and LDKTX, especially the laparoscopic organ retrieval, are effective concepts to increase the number of kidney transplantations.
10

Perceptions of the relatives of patients suffering from chronic renal failure regarding kidney donation

Mbeje, Nthombithini Pretty 06 1900 (has links)
This study aimed at exploring and describing the perceptions of relatives of patients with chronic renal failure regarding kidney donation. The number of patients suffering from chronic renal failure awaiting kidney transplantation is on the increase, while the treatment they get in the interim is not cost effective. The researcher used qualitative descriptive and exploratory research using the Potter and Perry’s Health Belief Model. She applied purposive sampling and used semi structured interviews to collect data from 45 participants who were all relatives of patients coming for haemodialysis at a selected hospital in KwaZulu-Natal. Data analysis identified participants’ perceptions regarding chronic renal failure and kidney donation. Findings of the study revealed that most relatives were fully aware of kidney donation, but fear and lack of knowledge regarding kidney transplantation were the main barriers to them offering themselves for kidney donation. The researcher recommends that the Renal Transplant Multidisciplinary Committee should ensure the public is informed about kidney donation and more intensive education should be given to the relatives of patients suffering from chronic renal failure at an early stage in the illness to give them more time to come to terms with the concept of kidney donation. / Health Studies / M.A. (Health Studies)

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