Browsing by Subject "Transplant Recipients"
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Item Association Between Posttraumatic Growth, Medication Adherence, and Barriers to Adherence in Pediatric Solid Organ Transplant Patients and Their Caregivers(2020-08-01T05:00:00.000Z) Mbroh, Hayden Mensah; Triplett, Kelli; Stewart, Sunita M.; McClintock, Shawn Michael; Bonsu, Mary L.; Selders, MichaelLiving with a chronic illness can be a traumatic experience, yet there is also evidence that adverse experiences may facilitate positive psychological changes, such as posttraumatic growth (PTG). Little is known about PTG in pediatric solid organ transplant (SOT) patients and their caregivers or PTG's relationship with health behaviors. Study aims were to longitudinally evaluate 1) the role of medication nonadherence and BTA on PTG, and 2) PTG's influence on medication nonadherence and barriers to adherence (BTA). It was hypothesized that 1) Greater baseline medication nonadherence and BTA would predict greater follow-up PTG, and 2) greater baseline PTG would predict lower follow-up medication nonadherence and fewer BTA. Participants included 43 pediatric SOT patient-caregiver dyads at baseline (range: .11-17.09 years post SOT) and follow-up (range: .87-3.37 years post baseline). Baseline measures of PTG, medication nonadherence, BTA, and psychosocial factors were obtained. Follow-up measures of primary outcomes were also collected. Baseline medication nonadherence (β = -.05, SE = .87), patient-rated BTA (β = -.17, SE = .10), and caregiver-rated BTA (β = -.24, SE = .12), did not predict follow-up patient PTG. More baseline caregiver-rated BTA (β = .29, SE = .30), but not medication nonadherence (β = .07, SE = 3.02) or patient-rated BTA (β = .20, SE = .20), predicted greater follow-up caregiver PTG. Baseline patient PTG (β = -.01, SE = .04) and caregiver PTG (β = -.25, SE = .01) did not predict follow-up medication nonadherence. Higher baseline caregiver PTG (β = -.25, SE = .08), but not patient PTG (β = -.07, SE = .26), predicted fewer follow-up patient-rated BTA. Greater baseline patient PTG (β = -.01, SE = .21), but not caregiver PTG (β = -.04, SE = .06), predicted more follow-up caregiver-rated BTA. Exploratory analyses were also conducted to identify psychosocial predictors of primary outcomes. Results suggest that strengthening PTG in caregivers of pediatric SOT patients may be important for reducing BTA. Further research needed to determine whether specific domains of PTG and BTA are associated. Findings have the potential to inform strength-based interventions focused on decreasing BTA for pediatric SOT patients.Item Comparison of Pre-Transplant Criteria and Outcomes for Living Donor Kidney Transplant Programs in India and the United States(2015-01-26) Bansal, Sukriti; Raja, Hari; Rajora, Nilum; Kher, VijayBACKGROUND: One of the greatest obstacles to treatment of end stage renal disease globally is organ donor shortage. While some nations (i.e. the US), have primarily cadaveric organ donors, developing nations rely heavily on living donors. This project is a comparison of two kidney transplants programs -- one in the US & one in India -- looking at the pre-transplant criteria of each & assessing the patient outcomes. METHODS: This is a cohort study of living donor kidney transplant patients from St. Paul University Hospital in Dallas, TX & kidney transplant patients from Medanta the Medicity in Gurgaon, India. Data for India was collected from a database of all patients who underwent a kidney transplant at Medanta, selected for patients who fit the following criteria: one cohort of patients had been transplanted the previous month (N=29), one cohort had been transplanted one year prior the date of the study (N=29), & one cohort had been transplanted 3 years prior (N=13). Information from the database was used to calculate patient & graft survival rates for the relevant time periods. Data for St. Paul was obtained from the Scientific Registry of Transplant Recipients, which already had the calculated 1 month, 1 year, & 3 year patient and graft survival rates. Information on pre-transplant criteria was obtained from the transplant teams at each respective institution. RESULTS: The majority of medical pre-operative criteria between the two programs are identical. One significant difference is ABO-incompatible transplants are performed at Medanta, while at St. Paul ABO-incompatible donor/recipient pairs are referred for paired donation. Medanta requires all living donors to be related, while St. Paul will accept unrelated donors. The patient survival rates for St. Paul are 100% (1 mo, N=32), 95.23% (1 yr, N=32) and 85.71 % (3 yr, N=21). Graft survival rates are 100% (1 mo, N=32), 95.24% (1 yr, N=32), and 81.82% (3 yr, N=22). The patient survival rates for Medanta are 100% (1 mo., N=29), 100% (1 yr, N=29), and 100% (3 yr, N=13). Graft survival rates are 100% (1 mo. N=29), 100% (1 yr, N=29), and 100% (3 yr, N=13). For all patients transplanted at Medanta, the overall patient survival rate was 98.40% (N=874) and the overall graft survival rate was 98.51% (N=874). Corresponding data wasn't available for St. Paul. CONCLUSION: While it appears that the 3 year survival rates are better for Medanta than for St. Paul, there is a limitation on making conclusions because this data does not encompass the entire program at Medanta. Further study is needed to truly assess if there is a significant difference. The overall conclusion is that transplant programs in both settings have successful outcomes.Item [News](1983-06-14) Williams, AnnItem [Southwestern News](2000-08-15) Best, Kent