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.

Esta pesquisa teve como objetivo conhecer a percepção de familiares de potenciais doadores sobre os motivos considerados para recusar a doação dos órgãos e tecidos para transplante. Para compreender a percepção dos familiares optou-se por realizar uma pesquisa qualitativa, segundo a modalidade \"estrutura do fenômeno situado\". Como forma de desvelar o fenômeno foram entrevistadas oito famílias, utilizando as seguintes questões norteadoras: \"Como foi a tomada de decisão para recusar a doação dos órgãos e tecidos para transplante do seu familiar falecido?\" e \"Quais os motivos considerados para recusar a doação?\". Após a obtenção das descrições, os discursos foram analisados individualmente, sendo feita a análise ideográfica, resgatando os seguintes temas e subtemas: \"Relatando a internação do familiar\", \"Vivenciando a perda do familiar\": \"Recebendo a informação da morte encefálica e a solicitação da doação\", \"Sofrendo com a perda do familiar\"; \"Decidindo pela recusa da doação dos órgãos\": \"Conversando sobre doação\", \"Respeitando a decisão tomada\"; \"Apresentando os motivos de recusa da doação dos órgãos\": \"A crença religiosa\", \"A espera de um milagre\", \"A não compreensão do diagnóstico de morte encefálica e a crença na reversão do quadro\", \"A não aceitação da manipulação do corpo\", \"O medo da reação da família\", \"A inadequação da informação e a ausência de confirmação da morte encefálica\", \"A desconfiança na assistência e o medo do comércio de órgãos\", \"A inadequação no processo de doação\", \"O desejo do paciente falecido, manifestado em vida, de não ser um doador de órgãos\" e \"O medo da perda do ente querido\". Buscou-se desvelar, pela análise nomotética, as convergências e divergências das unidades de significado interpretadas, em direção a estrutural geral do fenômeno. As proposições que emergiram revelaram que a essência do fenômeno \"A recusa familiar no processo de doação de órgãos e tecidos para transplante\" foi desvelada como vivenciar uma situação de choque e desespero com a internação do familiar, de desconfiança com a solicitação da doação dos órgãos, de negação da morte encefálica, de sofrimento e desgaste diante da perda do ente querido, de conflitos familiares para a tomada de decisão e de múltiplas causas para a recusa da doação / This research had as its target learn the perception of potential donator`s familiy on the considered reason for the organs and tissues donation refusal for transplant. In order to understand the family perception a qualitative research was chosen, according to the modality \"situated phenomena structure\". In way of unveil the phenomena eight families were interviewed, having these questions as a guide:\"How was the decision taken in order to refuse the organs and tissues donation for tranplant of your deceased next of kin?\" and \"Which are the reasons weight for the donation refuse?\". After getting the descriptions, the speech were individually analysed, where a ideographic analysis was taken, recovering the folowing themes and sub themes : \"Telling next of kin as in patient\", \"Witness the next of kin\'s loss\": \"Receiving the encephalic death information and the solicitation for donation\", \"Suffering the next of kin\'s loss\"; \"Taken the organs and tissues donation refuse\": \"Talking about donation\", \"Regarding the taken decision\"; \"Presenting the refusal organs and tissues donation reasons\": \"The religious belief \", \"A hope of miracle\" , \"The encephalic death diagnosis missuderstood and the believe of a reversion of the situation\", \"Disagreement on the body maneuver\", \"The worry of the family\'s reaction\", The information ineffectuality and the lack of the encephalic death confirmation\",. \"The assistance mistrust and the fear of organs market\", \"The deficiency of donation process\", \"The person\'s willing not to be an organ donator when alive\" and \"The fear of loosing the dearest next of kin\". Through out of the nomothetic analysis, the meaningfull units convergency and divergency been taken, directed to the general structure phenomena. The propositions which appeared shown that the phenomena essence \"The family refusal on the organs and tissues donation for transplant\" was unveiled as been trought a shock situation and disperation with the next of kin in patient situation, mistrust because of the organs and tissue donation requesting, the denying of encephalic death, suffering and exhausting before the loss of the beloved one, family conflicts in way of taken the decision and the multiple causes of organ and tissues donation refuse

A doença hepática terminal reduz de forma significativa a qualidade de vida de pacientes e com o transplante do órgão é possível melhorar as condições de saúde. A sexualidade é aspecto central do ser humano durante todo o ciclo vital. É área complexa do comportamento humano, assim a sexualidade de candidatos e receptores de transplante de fígado não deve ser menosprezada. O presente estudo teve como objetivo analisar as evidências disponíveis na literatura sobre as alterações na sexualidade de candidatos e receptores de transplante de fígado. Trata-se de revisão integrativa da literatura: as bases de dados selecionadas para a busca dos estudos primários foram PubMed, CINAHL e LILACS. Os 16 estudos primários incluídos na revisão foram agrupados em três categorias: (1) sexualidade feminina (n=5); (2) sexualidade masculina (n=5) e; (3) sexualidade masculina e feminina (n=6). Na categoria 1, os principais temas de investigação foram contracepção, gravidez, disfunção sexual, presença de sintomas ginecológicos e doença sexualmente transmissível. Na categoria 2, o foco principal dos estudos primários agrupados foi a disfunção erétil e investigou-se também desejo/satisfação sexual e as consequências de homens que tiveram filhos, em regime imunossupressor com ácido mycofenólico. Na categoria 3, a avaliação da função sexual foi o principal tema abordado nas pesquisas analisadas. A sexualidade é problemática desafiadora, revestida por tabus e preconceitos, vivenciada de forma diferente pelos indivíduos. Assim, os pacientes podem apresentar dificuldades em relatar para os profissionais da saúde seus problemas, acarretando atraso do diagnóstico e tratamento, prolongando a sensação de desconforto e sentimento de angústia. A dificuldade em abordar sobre sexualidade também ocorre por parte dos profissionais de saúde que não recebem capacitação adequada. O conhecimento sobre as dúvidas e problemas vivenciados pelos candidatos e receptores de transplante de fígado pode proporcionar a implementação de intervenções direcionadas para prevenção, redução ou controle das complicações no período pré e pós-transplante. O presente estudo forneceu subsídios para encorajar os profissionais de saúde a incorporar a sexualidade na rotina de atendimento destes pacientes, bem como indicou lacunas no conhecimento para a condução de novas pesquisas com o propósito de implementar intervenções na pratica clínica para prevenir, minimizar e/ou controlar as alterações relacionadas à sexualidade do paciente, contribuindo para a melhoria da assistência de enfermagem e, consequentemente, para o sucesso do tratamento / The end-stage liver disease significantly reduces the quality of life of patients. However, with organ transplantation it is possible to improve health conditions. Sexuality is a central aspect of the human being throughout the life cycle. It is a complex area of the human behavior and therefore the sexuality of liver transplant candidates and recipients should not be overlooked. The present study aimed to analyze the evidence available in the literature on the changes in the sexuality of candidates and recipients of liver transplant. This is an integrative literature review, and the databases selected for the search of the primary studies were PubMed, CINAHL and LILACS. The 16 primary studies included in the review were grouped into three categories: (1) female sexuality (n = 5), (2) male sexuality (n = 5) and (3) male and female sexuality (n = 6). In category 1, the main research topics were contraception, pregnancy, sexual dysfunction, presence of gynecological symptoms and sexually transmitted disease. In category 2, the focus of the primary studies grouped was erectile dysfunction, it was also investigated the sexual desire/satisfaction, and the consequences of men who had children under immunosuppressive regimen with mycophenolic acid. In category 3, the evaluation of sexual function was the main topic addressed in the studies analyzed. Sexuality is a challenging problem, enrobed with taboos and prejudices, and experienced differently by individuals. Thus, patients may present difficulties in reporting their problems to health professionals, leading to delays in diagnosis and treatment, prolonging feelings of discomfort and distress. The difficulty in addressing sexuality also occurs on the part of health professionals who do not receive adequate training. Knowledge about the doubts and problems experienced by candidates and recipients of liver transplant can facilitate the implementation of interventions aimed at prevention, reduction or control of complications in the pre- and post-transplantation period. The present study provided subsidies to encourage health professionals to incorporate sexuality in the care routine of these patients, it also indicated gaps in knowledge for the conduct of new research with the purpose of implementing interventions in clinical practice to prevent, minimize and/or to control the changes related to the patient\'s sexuality, contributing to the improvement of nursing care and, consequently, to the success of the treatment

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-21T17:23:47Z No. of bitstreams: 1 marcelodiasdecastro.pdf: 35449715 bytes, checksum: 86414e568f3ffb10fc5fe7e10b848a83 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T18:47:28Z (GMT) No. of bitstreams: 1 marcelodiasdecastro.pdf: 35449715 bytes, checksum: 86414e568f3ffb10fc5fe7e10b848a83 (MD5) / Made available in DSpace on 2016-01-25T18:47:28Z (GMT). No. of bitstreams: 1 marcelodiasdecastro.pdf: 35449715 bytes, checksum: 86414e568f3ffb10fc5fe7e10b848a83 (MD5) Previous issue date: 2014-06-06 / Diarréia é a maior causa de morbidade em pacientes submetidos a quimioterapia em altas doses e a transplante autólogo de células tronco hematopoéticas. Existem muitas causas de diarréia em pacientes que são transplantados, incluindo o efeito dos agentes quimioterápicos e as infecções. Neste estudo, foram avaliados 47 pacientes que receberam transplante no HU-UFJF entre maio de 2011 e maio de 2013. Todos os pacientes que apresentaram diarréia tiveram suas amostras de fezes enviadas para análise e pesquisa de agentes etiológicos através de exames específicos para fungos, coccídios, Strongyloides, parasitas intestinais, Clostridium difficile, e bactérias patogênicas. Trinta e nove pacientes (83%) tiveram diarréia, sendo que, destes, 35% tiveram diarréia induzida por quimioterapia, sete (17,5%) apresentaram coccídios, três (7,5%) tiveram Cândida sp, um (2,5%) Clostridium difficile e um paciente (2,5%) apresentou Giardia lamblia. Outros 30% apresentaram diarréia por outras causas. Houve uma tendência a mais diarréia em pacientes com mais de 50 anos (p=0.09), naqueles que receberam condicionamento com lomustina, etoposide, citarabina e melfalam (p=0.083) e houve um maior número de dias de neutropenia nos pacientes com diarréia (p=0.06). Porém nenhum fator de risco foi encontrado. Os dados apontam para a importância da correta identificação dos agentes etiológicos e da alta probabilidade de variações destes agentes em populações distintas. / Diarrhea is a major cause of morbidity for the patients undergoing high-dose chemotherapy and autologous hematopoietic stem cell transplantation (ASCT). There are multiple causes of diarrhea in patients undergoing transplantation incluing antineoplastic chemotherapy and infections. In this study, 47 patients underwent ASCT at the HU-UFJF between May 2011 and May 2013. All patients who presented with diarrhea consented to stool sample analysis for identification of the etiological agents through specific exams in search of fungi, coccidia, intestinal parasites, Strongyloides, C. difficile, and other pathogenic bacteria. Thirty-nine patients (83%) had diarrhea, among whom 35% had diarrhea induced by chemoterapy, seven (17.5%) presented with coccidia, three (7.5%) with Candida sp., one (2.5%) with C. difficile, and one (2.5%) with Giardia lamblia. Other 30% had diarrhea for other causes. There was a tendency toward a higher incidence of diarrhea in oldest 50 years (p=0.09) and those who received lomustine, etoposide, cytarabine, and melphalan conditioning (p=0.083) and a higher number of days of neutropenia in patients with diarrhea (p=0.06); however, no risk factors were identified. The results shows the importance of correctly identifying the etiological agent and highlights the possible varieties of agents in specific populations.

The targeted transplant center's abdominal organ transplant unit had difficulty providing adequate education to patients prior to discharge, which had resulted in a 24% readmission rate within 30 days due to infections. Patients and caregivers were unavailable to receive education despite multiple attempts, which made it challenging for health care providers to complete this aspect of their job, resulting in a negative impact on patients' long-term outcomes. A more structured educational environment was needed to provide appropriate and effective patient and caregiver education to increase adherence and positive outcomes. The health promotion model served as a foundation for the development of the evidence-based educational process and materials. A panel of 6 experts was invited to review the evidence-based, theory-supported educational materials along with the staff and caregiver educational process developed for the unit. Five experts participated in the formative and summative evaluation of the educational process, materials, and the evaluation tool. Results of the evaluations demonstrated that a majority (83%) of the experts found the educational materials and process were essential, accurate, and provided a more structured environment that afforded health care providers the ability to maintain compliance with the targeted transplant center's education policy. The materials, process, and evaluation tool will be implemented at the site. Social change will result from increased patient engagement and confidence in self-care; improved caregiver ability to assist the patient; and reduced risk of noncompliance, readmissions, and poor outcomes.

No description available.

Le stress du Réticulum Endoplasmique (RE) est impliqué dans la physiopathologie des maladies rénales, et la réponse UPR (Unfolded Protein Response), qui est activée en réponse à ce stress, joue un rôle important dans l'homéostasie des cellules tubulaires rénales et des podocytes. L’étude des mécanismes moléculaires et des conséquences de l'activation de cette voie est donc importante dans la compréhension de la physiopathologie des maladies rénales et dans la caractérisation de biomarqueurs de lésions évolutives. L’Angiogénine (ANG, appelée également RNase 5) est une ribonucléase secrétée, qui est impliquée dans la réponse à certains stress cellulaires, et permet une adaptation cellulaire et tissulaire.
L'objectif de ce travail a été de mettre en évidence les mécanismes de régulation et les fonctions biologiques de l'ANG en réponse au stress du RE. A partir d'un modèle de cellules tubulaires rénales humaines en culture, nous avons montré que le stress du RE induisait l’expression de l’Angiogénine ainsi que sa sécrétion. Cette observation a été également faite sur différents modèles murins de lésions rénales. Le facteur transcriptionel sXBP1, activé par le transducteur de la réponse UPR, IRE1a, est directement impliqué dans la régulation de l'expression de l'Angiogénine.
Nous avons mis en évidence que l'Angiogénine participait à l’inhibition de la traduction protéique en réponse au stress du RE en produisant des fragments d'ARN de transfert appelés tiRNAs (stress-induced tRNA fragments) qui répriment la traduction des protéines en interférant avec le complexe initiateur de la traduction. L'Angiogénine favorise la survie cellulaire en réduisant l'apoptose induite par le stress du RE, et des souris invalidées pour le gène codant l'Angiogénine sont plus sensibles aux lésions de nécrose tubulaire aigues induites par la Tunicamycine. Outre les propriétés cellulaires "intrinsèques" de l'Angiogénine, nous avons également caractérisé les mécanismes de sécrétion de l'Angiogénine par l'épithélium rénal en situation de stress du RE. La sécrétion épithéliale de l'Angiogénine est sous le contrôle des facteurs transcriptionnels NF-κB et sXBP1, et se produit sous un mode conventionnel, c’est-à-dire dépendant du transit par l'appareil de Golgi. A ce titre, la régulation de l'Angiogénine est similaire à celle de l'Interleukine 6. L'Angiogénine induit une polarisation des macrophages vers un phénotype pro-inflammatoire. Enfin, considérant que l'Angiogénine est secrétée par l'épithélium rénal en situation de stress, nous avons montré que l’Angiogénine peut être un marqueur non invasif de souffrance rénale. L'Angiogénine peut être quantifiée dans les urines de patients porteurs de maladies rénales, et sa concentration est corrélée à la concentration urinaire de Retinol Binding Protein (une protéine de petit poids moléculaire, marqueur de dysfonction tubulaire), mais pas avec celle de l'Albumine. En outre, la concentration urinaire d'Angiogénine est significativement plus élevée dans les urines de patients transplantés rénaux dont la biopsie rénale met en évidence des lésions de tubulite (rejet aigu cellulaire et néphropathie associée au BK virus) que dans les urines de patients indemnes de lésions tubulaires (rejet humoral, ou absence de lésions histologiques). Nous avons mis en évidence par immuno-histochimie un marquage nucléaire du facteur transcriptionnel sXBP1 dans les tubules de reins porteurs de lésions de tubulite, suggérant un lien potentiel entre sécrétion d'Angiogénine et activation du facteur transcriptionnel sXBP1 dans un environnement inflammatoire. En conclusion, nous avons intégré la régulation l'Angiogénine dans la réponse épithéliale rénale au stress du RE, et caractérisé ses fonctions biologiques intracellulaires et paracrines. Notre travail a identifié l'Angiogénine urinaire en étant que potentiel marqueur de lésions rénales tubulaires. / The Endoplasmic Reticulum (ER) stress is involved in the pathophysiology of renal diseases ; the UPR (Unfolded Protein Response), which is activated in response to that stress plays an important role in renal tubular cells and podocytes homeostasis and consequently in tissu homeostasis. Understanding the molecular mechanisms and the consequences of the activation of this pathway is important to characterize the pathophysiology of renal diseases and identification of biomarkers of ongoing lesions. Angiogenin (ANG, also known as RNase 5) is a secreted ribonuclease, which is involved in the cellular stress response, it allows cell and tissue adaptation. The goal of this work was to clarify and identify the mechanisms regulating Angiogenin’s expression and its biological functions during ER stress. Using a human renal tubular cell line, we have shown that ER stress induces the expression of angiogenin and its secretion. This observation was also made on several murine models of renal injury. The transcriptional factor sXBP1 activated by the UPR transducer, IRE1α, is directly involved in regulating the expression of angiogenin. We have shown that angiogenin participates in the inhibition of protein translation in response to ER stress by cleaving transfer RNA and generating tiRNAs (stress-induced tRNA fragments) that suppress protein translation by interfering with the translation initiation complex. Angiogenin promotes cell survival by reducing ER stress-induced apoptosis, ANG knockout mice are more sensitive to acute tubular necrotic lesions induced by tunicamycin. In addition to the cell-autonomous effects of angiogenin, we also characterized the mechanisms by which Angiogenin is secreted by the renal epithelium under ER stress. Angiogenin is secreted in a conventional manner under the control of the transcriptional factors NF-kB and sXBP1. As such, the regulation of angiogenin is similar to Interleukin-6. We also demonstrated that Angiogenin induces macrophage polarization to a pro-inflammatory phenotype. Finally, considering that angiogenin is secreted by the renal epithelium under stress, we have shown that angiogenin may be a noninvasive marker of kidney injury. Angiogenin can be quantified in the urine of patients with kidney disease, its urinary concentration is correlated to the urinary concentration of Retinol Binding Protein (a low molecular weight protein marker of tubular dysfunction), but not with that of Albumin . In addition, the urinary concentration of angiogenin is significantly higher in the urine of renal transplant patients whose renal biopsy highlights tubulitis lesions (cell acute rejection and BK virus associated nephropathy) than in the urine of patients without histological tubular damage (antibody-mediated rejection, or no visible histological lesions). We have demonstrated by immuno-histochemistry a tubular nuclear localization of the activated transcriptional factor sXBP1 in the biopsies of patients with high tubulitis score, suggesting a potential relationship between the secretion of Angiogenin and the activation of transcriptional factor sXBP1 within an inflammatory environment. To conclude, we have described Angiogenin as a new mediator of the integrated ER stress response, and characterized its cell- and non-cell-autonomous biological functions. Our study have identified urinary angiogenin as a potential marker of ongoing kidney tubular injuries.

No description available.

Die Hyperlipidämie wird als Risikofaktor für die Nierentransplantatfunktionsverschlechterung und den -verlust diskutiert. Wir untersuchten den Zusammenhang zwischen Lipidstoffwechsel und Nierentransplantatfunktion und ihre Beziehungen zu Immunsuppression, Rejektionen, Transplantatalter und Dialysedauer. Im 1. Quartal 1996 wurde allen nierentransplantierten Patienten der Ambulanz die Bestimmung eines umfassenden Lipidstatus (Cholesterine (HDL, LDL, VLDL), Triglyzeride, Apolipoproteine A1, A2, B, Lp(a) und Apo E-Genotyp) angeboten. Die ermittelten Laborwerte wurden zum klinischen Verlauf der Patienten in Beziehung gesetzt. Es wurden 201 Patienten in die Studie eingeschlossen, deren mittleres Alter bei 46,2 ± 11,4 Jahren lag. Die Transplantation lag bei den 146 Männer (72,6 %) und 55 Frauen (27,4 %) 7,7 ± 4,9 Jahre zurück. Eine auf Cyclosporin A basierende Immunsuppression erfolgte bei 143 Patienten (71,1 %), 87 Patienten (43,3 %) erhielten eine lipidsenkende Therapie. Kreatinin 122 ± 86,9 µmol/l; Cholesterin 253,6 ± 52,9 mg/dl; atherogene Risikoratio (Chol/HDL) 5,3 ± 2,3. Das Kreatinin korreliert signifikant mit dem Cholesterin (p < 0,001) und der atherogenen Risikoratio (p < 0,001) - auch in der Untergruppe ohne lipidsenkende Therapie (p = 0,001 bzw. p < 0,001), ebenso LDL, Triglyzeride, VLDL und Apo B. Die Rejektionshäufigkeit war bei Patienten mit und ohne Fettstoffwechselstörung nahezu gleich. Der Apo E-Genotyp scheint keinen Einfluss auf den Lipid- und Nierenstoffwechsel zu haben. Die Lipidparameter unserer Patienten korrelieren in der Querschnittsuntersuchung signifikant mit der Nierentransplantatfunktion, scheinen aber keinen Einfluss auf die Rejektionshäufigkeit zu haben / Hyperlipidemia is discussed as a risk factor for deterioration of the renal transplant function and the graft loss. We examined the relations between the lipid metabolism and renal transplant function and their connections to factors like immunsuppression, rejections, transplant age und time of dialysis. In the first months of 1996 all patients having a renal transplant were offered an extensive blood control including cholesterol, HDL, LDL, VLDL, triglycerides, apolipoproteins A1, A2, B, Lp(a) und Apo E-Genotype. Afterwards the lipid parameters were put into relation to the clinical course of each patient. We included 201 patients in our study, they were 46,2 ± 11,4 years old. The renal transplantation was in 146 men (72,6 %) und 55 women (27,4 %) 7,7 ± 4,9 years ago. 143 patients got a Cyclosporin A based immunsuppression (71,1 %), 87 patients (43,3 %) were set on lipid lowering therapie. Creatinin 122 ± 86,9 µmol/l; cholesterol 253,6 ± 52,9 mg/dl; Chol/HDL-quotient 5,3 ± 2,3. Creatinin correlates significantly with cholesterol (p < 0,001) and the Chol/HDL-quotient (p < 0,001) - even in the group of patients without lipid lowering therapie (p = 0,001 and p < 0,001) - and LDL, Triglyzeride, VLDL and Apo B. The frequency of rejections did not differ between patients with and without hyperlipidemia. The Apo E-Genotype seems to have no influence on the lipid- and renal metabolism. The lipid parameters our patients correlate in our study significantly with the renal transplant function, but seem to have no influence on the frequency of rejections.

Made available in DSpace on 2016-01-26T12:51:20Z (GMT). No. of bitstreams: 1 helenacatharinecamarerodefelicio_dissert.pdf: 1266538 bytes, checksum: 8e51ee02a7424654eda7e0709c1202e3 (MD5) Previous issue date: 2007-04-27 / Liver transplantation is currently indicated for chronic and acute liver failure when no other treatment is available. As a complex procedure, it requires interdisciplinary care and the patients and caregivers´ compliance behavior. Objectives: to obtain from liver recipients, transplant candidates, families and health care professionals what kind of information they considered sufficient or insufficient about liver transplantation; to use the obtained data to elaborate a manual with information identified as relevant and necessary. Method: this is a descriptive study approved by the Ethics Committee and conducted at the Unity of Surgery and Liver and Large Intestine Transplant, Hospital de Base, Sao Jose do Rio Preto, S.P. A total of 50 liver transplant candidates , 50 caregivers of these patients , 50 recipient patients and 24 health care professionals from this unity comprised the study. All patients and caregivers were interviewed in the Outpatient Service and in the Transplant Unit by the research nurse. All professionals received a questionnaire; afterwards the answers were returned to the researcher. Results: Most patients were male: liver recipients (41 men; mean age: 47.52; sd: 11.7); candidate patients (30 men; mean age: 48.02; sd:10.29). The Group of caregivers (n: 37) and professionals (n: 15) comprised mostly women. Professional team comprised physicians, nurses, psychologists, social workers, nutritionists and physical therapists. Recipients related insufficient information (p<0.032) concerning their disease, exams, waiting list, pre- and postsurgery periods, immunosupressor drugs, rejection and complications and follow-up at the outpatient clinic. Candidate patients considered they had insufficient information (p<0.032) about their disease (liver functioning, cyrrhosis, severity and complications); about the treatment (exams and protocol); surgery (need for surgery and donor); pre-, intra and postoperative periods (hospital arrival, exams and procedures at the operating room, duration and risks of surgery and ICU) and follow-up (rejection, retransplantation, immunosupressors, diet and follow-up). Caregivers had insufficient information (p<0.032) about the disease, exams, treatment, waiting list, quality of life, hospitalization, protocol, pré-, intra e postoperative periods, immunosupressor drugs , rejection and complications, retransplantation, pre- and post diet, hospital discharge and outpatient follow-up. Professionals´ answers pointed out topics related to their own specialties . Conclusions: even thought all health care professionals provide information; patients and caregivers still report not to have enough information about the whole process of liver transplantation. An orientation manual was elaborated based on the obtained data. / O transplante de fígado é indicado para hepatopatias crônicas ou agudas para as quais não existe outro tratamento disponível. É um processo complexo que requer atendimento interdisciplinar e comportamentos de adesão por parte do paciente e cuidador. Este estudo teve como objetivos: a) identificar informações consideradas suficientes ou não sobre o transplante na perspectiva de pacientes transplantados e candidatos ao transplante, familiares e profissionais; b) elaborar manual de orientações para pacientes e familiares a partir dos dados obtidos, contendo informações identificadas como relevantes e necessárias. Casuística e Método: estudo descritivo, aprovado por Comitê de Ética em Pesquisa e realizado na Unidade de Cirurgia e Transplante de Fígado e Intestino Delgado do Hospital de Base de São José do Rio Preto, SP. Participaram 50 pacientes em lista de espera para transplante de fígado, 50 familiares (cuidadores) de pacientes em lista, 50 pacientes já transplantados e 24 profissionais da equipe interdisciplinar da Unidade. Foram realizadas entrevistas estruturadas com os pacientes e familiares. Os profissionais receberam questionários que foram respondidos e entregues posteriormente. Resultados: A maior parte dos pacientes era do sexo masculino: transplantados (41 homens; média de idade do grupo: 47,52; dp: 11,7); em lista (30 homens; média de idade do grupo:48,02; dp: 10,29). Os grupos de cuidadores e de profissionais foram principalmente do sexo feminino: n: 37 e n:15, respectivamente. Os profissionais da equipe eram médicos, enfermeiras, psicólogos, assistentes sociais, nutricionistas e fisioterapeutas. Foram consideradas insuficientes (p&#8804;0,032) para os transplantados informações sobre a doença, exames, fila de espera, protocolo, pré e pós-operatório, medicação imunossupressora, rejeição e complicações e seguimento ambulatorial. Para os pacientes em lista foram consideradas insuficientes (p&#8804;0,032) informações sobre a doença, tratamento, cirurgia, pré, intra e pós-operatório (chegada ao hospital, exames, procedimentos no centro cirúrgico, duração e riscos da cirurgia e UTI) e acompanhamento (rejeição, retransplante, imunossupressores, alimentação e seguimento). Para os cuidadores foram consideradas insuficientes (p&#8804;0,032) informações sobre a doença, exames, alimentação, tratamento, fila de espera, qualidade de vida, internações, protocolo, pré, intra e pós-operatório, medicação imunossupressora, rejeição e complicações, retransplante, alimentação, alta e seguimento ambulatorial. As respostas dos profissionais enfatizaram questões relacionadas às diversas especialidades. Conclusões: Embora informações sejam fornecidas por todos os profissionais da equipe, pacientes e cuidadores ainda percebem possuir informações insuficientes sobre todo o processo. Um manual contendo as orientações foi elaborado com base nos dados obtidos.