1
|
Galani V, Mazzola V, Prada P, Bondolfi G. Postoperative factors associated with psychological well-being of living kidney donors: results of a retrospective and qualitative study. Front Psychol 2024; 15:1377771. [PMID: 39035089 PMCID: PMC11258034 DOI: 10.3389/fpsyg.2024.1377771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 06/10/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Kidney transplantation from a living donor is the treatment of choice for end- stage kidney disease. Psychological implications of living kidney donation are of great importance, both during preliminary psychiatric assessment and post-donation follow-up. The identification of risk factors worsening the psychological well-being of living kidney donors (LKDs), before and after donation, remains challenging in terms of research. Methods At the University Hospitals of Geneva (HUG), our clinical observations and practice compelled us to establish post-donation follow-ups for LKDs at 6 months and 1 year. Pre-and post-donation sociodemographic, physical, psychological, and psychiatric data was collected from the medical records of 115 LKDs who underwent a complete physical and psychological evaluation during the period 2011-2018. We tested for any potential association between the variables under study. Results A qualitative and retrospective analysis of this data highlighted the impact of postoperative factors, such as pain, fatigue, recipient-donor relationship, and fulfillment of donors' expectations, on the post-donation psychological well-being of LKDs. Discussion With regard to these findings, regular post-donation follow-ups, optimal care of postoperative pain and fatigue, as well as a solid therapeutic alliance with LKDs remain key points for clinicians involved in the dynamic process of living kidney donation.
Collapse
Affiliation(s)
- Vasiliki Galani
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Viridiana Mazzola
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Paco Prada
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Guido Bondolfi
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
2
|
Massey EK, Rule AD, Matas AJ. Living Kidney Donation: A Narrative Review of Mid- and Long-term Psychosocial Outcomes. Transplantation 2024:00007890-990000000-00794. [PMID: 38886889 DOI: 10.1097/tp.0000000000005094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Living kidney donors make a significant contribution to alleviating the organ shortage. The aim of this article is to provide an overview of mid- and long-term (≥12 mo) living donor psychosocial outcomes and highlight areas that have been understudied and should be immediately addressed in both research and clinical practice. We conducted a narrative review by searching 3 databases. A total of 206 articles were included. Living donors can be divided into those who donate to an emotionally or genetically related person, the so-called directed donors, or to an emotionally or genetically unrelated recipient, the so-called nondirected donors. The most commonly investigated (bio)psychosocial outcome after living donation was health-related quality of life. Other generic (bio)psychological outcomes include specific aspects of mental health such as depression, and fatigue and pain. Social outcomes include financial and employment burdens and problems with insurance. Donation-specific psychosocial outcomes include regret, satisfaction, feelings of abandonment and unmet needs, and benefits of living kidney donation. The experience of living donation is complex and multifaceted, reflected in the co-occurrence of both benefits and burden after donation. Noticeably, no interventions have been developed to improve mid- or long-term psychosocial outcomes among living donors. We highlight areas for methodological improvement and identified 3 areas requiring immediate attention from the transplant community in both research and clinical care: (1) recognizing and providing care for the minority of donors who have poorer long-term psychosocial outcomes after donation, (2) minimizing donation-related financial burden, and (3) studying interventions to minimize long-term psychosocial problems.
Collapse
Affiliation(s)
- Emma K Massey
- Erasmus Medical Center Transplant Institute, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam, Zuid Holland, the Netherlands
| | - Andrew D Rule
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | - Arthur J Matas
- Department of Surgery, Transplantation Division, University of Minnesota, Minneapolis, MN
| |
Collapse
|
3
|
Min K, Hwang Y. Factors associated with the quality of life of living kidney donors in Korea: A cross-sectional study. Medicine (Baltimore) 2024; 103:e38068. [PMID: 38728517 PMCID: PMC11081590 DOI: 10.1097/md.0000000000038068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
This study investigated the relationship between self-determination, physical health status, and Health related Quality of Life (=HRQoL) among living kidney donors. A descriptive survey was conducted between 2019 and 2020 and included 111 kidney donors. Data were collected using a self-report questionnaire on general and donation-related characteristics, self-determination, and HRQoL. The data also included medical records reflecting the physical health status at the time of the survey. Data were analyzed using a multiple regression model. Factors associated with HRQoL were perceived health recovery after donation (β = 0.42, P < .001), up to 1 year since donation (β = 0.33, P = .008), more than 1 up to 5 years since donation (β = 0.52, P < .001), more than 5 up to 10 years since donation (β = 0.53, P < .001), and competence of self-determination (β = 0.23, P = .033). The explanatory power of these variables was 43.3%. HRQoL of living kidney donors can be affected by subjective and psychological factors. Therefore, health care providers should help living kidney donors have high self-determination during pre and post donation and concentrate on the subjective and psychological factors as well as objective health status.
Collapse
Affiliation(s)
- Kyungok Min
- Transplantation Center, Seoul National University Hospital, Seoul, South Korea
| | - Younghui Hwang
- Department of Nursing Science, College of Medicine, Chungbuk National University, Cheongju, South Korea
| |
Collapse
|
4
|
Willis F, Buck L, Musa J, Hinz U, Mechtersheimer G, Seidensaal K, Fröhling S, Büchler MW, Schneider M. Long-term quality of life after resection of retroperitoneal soft tissue sarcoma. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:106977. [PMID: 37481390 DOI: 10.1016/j.ejso.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/27/2023] [Accepted: 07/03/2023] [Indexed: 07/24/2023]
Abstract
INTRODUCTION Retroperitoneal soft tissue sarcoma (RPS) is characterized by high recurrence rates. Since complete tumor resection, often necessitating multivisceral resection, enables long-term survival in both primary and recurrent disease, health related quality of life (QoL) after RPS resection has attracted increasing interest. However, data regarding this topic is limited. Here, we multidimensionally assessed long-term QoL after RPS resection. METHODS Five previously validated (1. EORTC QLQ-C30, 2. WEMWBS, 3. FoP-Q-SF, 4. PC-PTSD, 5. Pro-CTCAE) were sent to patients having undergone resection of primary, recurrent and metastasized RPS at Heidelberg University Hospital between 10/2001 and 12/2020. Multivariable linear regression models were used to test associations between clinical/demographic variables and patient reported outcomes (PROs). RESULTS Questionnaires were answered by 127 patients (71% response rate). The median interval between RPS diagnosis and assessment of PROs was 80 months. The overall Global Health score was 64.1 and comparable to the general German population. RPS patients reported deficits regarding emotional and social functioning, whereas physical limitations were less pronounced. Besides diarrhea, abdominal symptoms were comparable to the overall population. Tumor recurrences, the number of surgeries, multivisceral resections or postoperative complications did not significantly affect long-term QoL ratings. CONCLUSION RPS patients rate their QoL relatively high, even after multiple and multivisceral resections. Psychosocial well-being should be monitored in follow-up sessions to offer tailored support if necessary, thus improving postoperative care.
Collapse
Affiliation(s)
- Franziska Willis
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Lena Buck
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Julian Musa
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany; Division of Translational Pediatric Sarcoma Research (B410), German Cancer Research Center (DKFZ), Heidelberg, Germany; Hopp-Children's Cancer Center (KiTZ), Heidelberg, Germany
| | - Ulf Hinz
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Katharina Seidensaal
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan Fröhling
- Division of Translational Medical Oncology, National Center for Tumor Diseases Heidelberg and German Cancer Research Center, Heidelberg, Germany
| | - Markus W Büchler
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Martin Schneider
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
| |
Collapse
|
5
|
Lagging E, Wadström J, Krekula LG, Tibell A. Red Flags in the Living Kidney Donor Process. Transplant Proc 2023; 55:279-287. [PMID: 36797163 DOI: 10.1016/j.transproceed.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 01/06/2023] [Accepted: 01/24/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Ideally, no live kidney donor should regret their decision or feel they were not fully prepared for the process. Unfortunately, this is not a reality for all donors. The aim of our study is to identify areas for improvement, focusing on factors (red flags) that predict less favorable outcomes from a donor perspective. MATERIALS AND METHODS A total of 171 living kidney donors responded to a questionnaire with 24 multiple-choice questions and space for comments. Less favorable outcomes were defined as lower satisfaction, extended physical recovery period, long-term fatigue, and longer sick leave. RESULTS Ten red flags were identified. Of these factors, more fatigue (range, P = .000-0.040) or pain (range, P = .005-0.008) than expected while still in hospital, the actual experience being harder or different than expected (range, P = .001-0.010), and the donor wishing to have had but not having been offered a previous donor as mentor (range, P = .008-.040) correlated significantly with at least 3 of the 4 less favorable outcomes. Another significant red flag was keeping existential issues to oneself (P = .006). CONCLUSION We identified several factors indicating that a donor could be at an increased risk for a less favorable outcome after donation. Four of these factors have, to our knowledge, not been described earlier: more early fatigue than expected, more postoperative pain than anticipated, not having been offered a mentor at an early stage, and keeping existential issues to oneself. Attention to these red flags already during the donation process could help health care professionals to act early to avoid unfavorable outcomes.
Collapse
Affiliation(s)
- Eva Lagging
- Center for Health Care Ethics, LIME, Karolinska Institutet, Stockholm, Sweden; Regional Donation Center Stockholm-Gotland, Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
| | - Jonas Wadström
- Department of Transplantation Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Linda Gyllström Krekula
- Center for Health Care Ethics, LIME, Karolinska Institutet, Stockholm, Sweden; Regional Donation Center Stockholm-Gotland, Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Annika Tibell
- Center for Health Care Ethics, LIME, Karolinska Institutet, Stockholm, Sweden; Department of Research, Education and Innovation, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
6
|
Lauridsen MB, Skov K, Øzbay LA. Short-term Outcome of Danish Kidney Donors: Postoperative Complications and Labor Affiliation. Transplant Proc 2022; 54:1763-1767. [PMID: 35868874 DOI: 10.1016/j.transproceed.2022.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/22/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Living kidney donation is safe and effective, but disincentives to donation include risk of short- and long-term complications, which need to be addressed in order to ensure care of live kidney donors. METHODS From January 1, 2016 to December 31, 2019, 123 living kidney donors (LKDs) underwent LKD nephrectomy at Aarhus University Hospital, Aarhus, Denmark. Data from The Scandiatransplant registry and patient records were reviewed in order to identify short-term postoperative complications within 90 days after donation, as well as affiliation to the labor market and health data at follow-up. The Clavien-Dindo classification of surgical complications with modifications by Kocak et al was used to categorize minor and major complications. RESULTS There were available data for 119 of 123 LKDs. Of these, 25 (21%) developed minor complications and 4 (3%) developed major complications. Ninety LKDs (76%) had an uneventful course without any complications. The most common complications were pain and nausea that required additional medical treatment. Seventy-two of the 82 LKDs working before donation had returned to work within 3 months after donor nephrectomy. No one retired or became disabled as a result of being a live kidney donor. CONCLUSIONS Short-term follow up of the LKDs showed that most donors experienced an uneventful course and that the frequency of major complications was low. Donation did not seem to impact the ability to resume work. At the 90-day follow-up the majority of donors with both minor and major complications resumed work and reported full convalescence at the same level as donors without any complications. Nine of the LKDs (8%), all women, were out of work for >3 months with the main reason being fatigue.
Collapse
Affiliation(s)
| | - Karin Skov
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lara Aygen Øzbay
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.
| |
Collapse
|
7
|
Westenberger A, Nöhre M, Brähler E, Morfeld M, de Zwaan M. Psychometric properties, factor structure, and German population norms of the multidimensional fatigue inventory (MFI-20). Front Psychiatry 2022; 13:1062426. [PMID: 36606126 PMCID: PMC9807811 DOI: 10.3389/fpsyt.2022.1062426] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The Multidimensional Fatigue Inventory (MFI-20) is commonly used, but its factor structure remains unclear. The MFI-20 consists of five subscales (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue). This study investigates the psychometric properties, including the factor structure, of a general German population sample and tests group hypotheses on gender and age. Another objective is to provide normative data by gender and age groups. METHODS Using data from a representative German sample (n=2,509), reliability and convergent validity measures, group hypothesis testing, and confirmatory/exploratory factor analyses were conducted. RESULTS The MFI-20 demonstrated satisfactory internal consistency and showed adequate convergent validity with the SF-36. All subscales of the MFI-20 were significantly correlated (0.71-0.85). Physical fatigue exhibited the highest (0.42) and mental fatigue had the lowest (0.19) correlation with age. Fatigue scores were significantly higher for women and significantly increased with age. A five-factor structure showed poor model fit; using an exploratory factor analysis, a two-factor structure emerged (a general factor and a mental/motivational factor). CONCLUSION The MFI-20 is a reliable and valid instrument for measuring fatigue in the general population, but the five-factor structure is not supported. The subscale general fatigue or the MFI-20 total score might measure fatigue sufficiently. The provided norms can be used for further research and individual assessment.
Collapse
Affiliation(s)
- Adrian Westenberger
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Elmar Brähler
- Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,Department of Psychosomatic Medicine, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Matthias Morfeld
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Sachsen-Anhalt, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| |
Collapse
|
8
|
Mental Health and Well-Being of Solid Organ Transplant Donors. The Forgotten Sacrifices. TRANSPLANTOLOGY 2021. [DOI: 10.3390/transplantology2030026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In light of a global organ shortage, living donor transplantation has become increasingly relevant as an alternative to deceased donor transplantation. While current research has revolved around the medical aspects of transplantation, there remains a paucity of literature regarding the quality of life (QOL) of living donors. Hence, this review aims to provide a comprehensive outline of the current landscape of living liver and kidney transplantation, with a focus on the mental health and wellbeing of donors. As highlighted in previous studies, organ donation has a significant impact on both physical and mental aspects of donor wellbeing, with marked deteriorations occurring in the short term. Furthermore, other qualitative aspects such as financial burden contribute greatly to donor distress, reflecting a need for improved donor care. To address these pertinent issues, recommendations for a successful transplant program are detailed in this review, which encompasses psychological and social aspects of donor care throughout the donation process. Further research can be done on the impact of recipient deaths on donor QOL and appropriate interventions. Overall, given the selfless sacrifices of living donors, the care of their mental wellbeing is essential. Therefore, greater emphasis should be placed on the provision of adequate psychosocial support for them.
Collapse
|
9
|
Samala N, Desai A, Vilar-Gomez E, Smith ER, Gawrieh S, Kettler CD, Pike F, Chalasani N. Decreased Quality of Life Is Significantly Associated With Body Composition in Patients With Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol 2020; 18:2980-2988.e4. [PMID: 32360826 DOI: 10.1016/j.cgh.2020.04.046] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/20/2020] [Accepted: 04/17/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS We studied impaired quality of life (QOL) and its determinants among individuals with nonalcoholic fatty liver disease (NAFLD). METHODS We collected data from 341 patients with NAFLD who completed the short form 36 (SF-36) questionnaire. Body composition and liver fibrosis were assessed in patients with NAFLD using bioelectrical impedance and transient elastography, respectively. Advanced fibrosis was defined as liver stiffness measurements (LSMs) of 12.1 kPa or greater. SF-36 scores of patients with NAFLD were compared with SF36 scores of individuals with chronic medical illnesses and the general population obtained from the published literature. RESULTS Among patients with NAFLD, percent body fat was negatively associated with scores from all 8 SF-36 scales, whereas lean body mass was positively associated with scores from 5 of 8 SF-36 scales. On multivariable analysis, SF-36 PF scores were negatively associated with type 2 diabetes, body mass index, and LSM and positively associated with lean body mass and level of alanine aminotransferase. Patients with NAFLD, and even those without advanced fibrosis, had significantly lower mean QOL scores than the control group or the general population. CONCLUSIONS Individuals with NAFLD, even those without advanced fibrosis, have lower QOL than controls. Body composition associates with QOL in patients with NAFLD; both of the modifiable factors independently associated with QOL are related to body composition. Further studies are needed to investigate if interventions to improve body composition can increase QOL for patients with NAFLD.
Collapse
Affiliation(s)
- Niharika Samala
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Archita Desai
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Eduardo Vilar-Gomez
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Emily R Smith
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Samer Gawrieh
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Carla D Kettler
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Francis Pike
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Naga Chalasani
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
| |
Collapse
|
10
|
Fleishman A, Khwaja K, Schold JD, Comer CD, Morrissey P, Whiting J, Vella J, Kayler LK, Katz D, Jones J, Kaplan B, Pavlakis M, Mandelbrot DA, Rodrigue JR. Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study. Am J Transplant 2020; 20:2522-2529. [PMID: 32185880 PMCID: PMC7483675 DOI: 10.1111/ajt.15861] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/14/2020] [Accepted: 03/03/2020] [Indexed: 01/25/2023]
Abstract
Postoperative pain is an outcome of importance to potential living kidney donors (LKDs). We prospectively characterized the prevalence, severity, and patterns of acute or chronic postoperative pain in 193 LKDs at six transplant programs. Three pain measurements were obtained from donors on postoperative Day (POD) 1, 3, 7, 14, 21, 28, 35, 41, 49, and 56. The median pain rating total was highest on POD1 and declined from each assessment to the next until reaching a median pain-free score of 0 on POD49. In generalized linear mixed-model analysis, the mean pain score decreased at each pain assessment compared to the POD3 assessment. Pre-donation history of mood disorder (adjusted ratio of means [95% confidence interval (CI)]: 1.40 [0.99, 1.98]), reporting "severe" on any POD1 pain descriptors (adjusted ratio of means [95% CI]: 1.47 [1.12, 1.93]) and open nephrectomy (adjusted ratio of means [95% CI]: 2.61 [1.03, 6.62]) were associated with higher pain scores across time. Of the 179 LKDs who completed the final pain assessment, 74 (41%) met criteria for chronic postsurgical pain (CPSP), that is, any donation-related pain on POD56. Study findings have potential implications for LKD education, surgical consent, postdonation care, and outcome measurements.
Collapse
Affiliation(s)
- A Fleishman
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - K Khwaja
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - JD Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - CD Comer
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA
| | - P Morrissey
- Transplant Center, Rhode Island Hospital, Providence, RI
| | - J Whiting
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - J Vella
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - LK Kayler
- Montefiore Einstein Center for Transplantation, Bronx, NY,Regional Center of Excellence for Transplantation & Kidney Care, Erie County Medical Center, University of Buffalo, Buffalo, NY
| | - D Katz
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - J Jones
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - B Kaplan
- Baylor Scott and White Health, Temple, TX
| | - M Pavlakis
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - DA Mandelbrot
- Department of Medicine, University of Wisconsin, Madison, WI
| | - JR Rodrigue
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | | |
Collapse
|