Multimedia Approach to Living Donation Education for Transplant Professionals: Building a Professional Society Multimedia Work Group.

Live Donor Liver Transplantation: Is It Better Than Waiting?

Living donor liver transplantation

Pre-emptive kidney transplants have not been favored in some centers because of concern about possible increased noncompliance and allegedly inferior long-term results. We analyzed our experience with pre-emptive kidney transplants to determine whether such concerns are justified. Between January 1, 1984, and June 30, 1998, we performed 1849 adult primary kidney transplants: 385 pre-emptive (recipients not undergoing dialysis, ND) and 1464 non-pre-emptive (recipients undergoing dialysis, D). Results were subdivided by donor source: cadaver (CAD) and living donor (LD). ND recipients tended to be younger, but otherwise, the two groups were similar. Posttransplantation quality of life in recipients was evaluated using the nationally standardized Short Form Health Survey (SF-36). The posttransplantation employment status of the recipients was also evaluated. The patient survival rate 5 years posttransplantation was significantly better for ND (vs. D) recipients for both CAD (92.6% vs. 76.6%, P=0.001) and LD (93.3% vs. 89.5%, P=0.02) transplants. The 5-year patient survival rate was significantly higher for ND recipients compared with recipients undergoing dialysis for < 1, 1-2, and > 2 years pretransplantation for both CAD (P=0.0005) and LD (P=0.0001) transplants. The graft survival rate 5 years posttransplantation was similar between ND and D recipients for CAD transplants, but significantly better for ND (vs. D) recipients of LD transplants (92.3% vs. 84.8%, P=0.006). For CAD transplants, the 5-year graft survival rate was not different when ND recipients were compared with recipients undergoing dialysis for < 1, 1-2, and > 2 years pretransplantation; for LD transplants it was significantly higher for ND recipients compared with recipients undergoing dialysis for < 1, 1-2, and > 2 years pretransplantation (P=0.04). The incidence of acute and chronic rejection was no different between ND and D recipients for either CAD or LD transplants, and it was also not affected by the pretransplantation time undergoing dialysis. Graft loss secondary to the recipient's discontinuation of immunosuppressive therapy (a crude estimate of compliance) was similar between ND and D recipients. Five years posttransplantation, the SF-36 scores regarding the recipient's quality of life and the employment status were similar for ND compared with D recipients, regardless of donor source. ND recipients do not seem to have higher rates of noncompliance than D recipients. Results for ND recipients seem to be superior than for D recipients, supporting the contention that renal failure patients should, if possible, undergo transplantation before dialysis.

Experiences of the Live Organ Donor: Lessons Learned Pave the Future Dianne LaPointe Rudow Introduction The experience of a live organ donor is multi–faceted and is as unique as each person who agrees to take a risk to save another. Factors include: type of organ donated (kidney vs. liver), relationship to the recipient (related—biological or non–biological vs. non–related), decision–making and motivation for donation, support systems available within and outside of the transplant program, and outcomes of the donation for both recipient and donor. The variety of experiences is apparent in the narratives within this special issue. I want to thank the authors of each story for sharing their experiences of the live donation process. As difficult as it must have been to write, it was difficult for someone like me, a transplant professional who is a strong advocate for quality donor care, to hear. But with each success and failure of transplantation, we can learn in the hopes of improving things for the next. Despite the fact that the field of transplantation is over 50 years old and the first kidney donors were live donors, viewing the field of live donation as a subspecialty of transplantation is a new concept (LaPointe Rudow, 2011). Live donation is, in fact, as specialized as lung transplant, liver transplant, transplant infectious disease, and kidney transplant. All of those subspecialties have clinicians and researchers with expertise in the area. Live donation experts exist and teams of live donor professionals staff most transplant programs today. Additionally regulatory bodies, professional societies, and advocacy groups strive to improve the care of the live organ donor (Medicare Conditions of Participation, 2007; Organ Procurement and Transplant Network, 2011; National Kidney Foundation 2011). Many years have been spent perfecting the surgical procedure and refining the proper testing to ensure that donation is safe for the donor. Live donation is, however, more than a surgery; in recent years, transplant professionals acknowledge that the psychosocial impact of donation on donors, whether positive or negative, can be significant but it is not yet completely understood. Much debate has occurred as to the components of the psychosocial evaluation, length and type of follow up, and the role of the independent live donor advocate (Amsterdam Forum, 2005; Ommen et al. 2011; Pruett et. al. 2006; Schroder et. al. 2008; Simpson & Pomfret 2012). The ethical concepts of paternalism and autonomy are in tension as we attempt to justify live donation. Perhaps nowhere else is ethical deliberation more vigorous than in the debate regarding whether informed consent for live donation is attainable, driven largely by the plight of the patient and the consequent vulnerability of the donor in an effort to help the patient. These quandaries are illustrated in the compelling narratives of this special issue. [End Page 45] Narrative Themes Based on an analysis of the narratives, I will present a series of dominant themes that emerged from the stories; these will be exemplified by illustrative quotations from the live donor’s narratives. Live Donation has Psychological Effects on the Donor There are many psychological effects of live donation both pre–and post–donation. The narratives describe feelings such as “I felt like a hero,” “feelings of anxiety, anger and ambivalence,” “it’s the best thing I ever did,” “I would do it all over again,” “a sense of loss,” and feelings of “suicidal thoughts.” The dichotomy of feelings expressed demonstrates the uniqueness of the live donor experience. One donor has nothing but good things to report regarding his or her experience while another feels lasting ill emotional affects requiring ongoing counseling even though the recipient has done well. Pre–donation psychological issues Traditionally, the psychosocial evaluation explores the pre–donation emotional and family stressors to ensure that there are no issues or underlying psychiatric disorders that will make donation high risk for psychological complications. All donors writing the narratives were found to be suitable donors. That being said, there is no standardized approach to the psychological evaluation. Organ Procurement and Transplant Network (OPTN)/United Network for Organ Sharing (UNOS) (Organ Procurement and Transplant Network, 2011) have policies and guidelines and the Centers for Medicare Conditions of Participation (COP) (Medicare Conditions of...

Variation in Dialysis Exposure Prior to Nonpreemptive Living Donor Kidney Transplantation in the United States and Its Association With Allograft Outcomes

Background Kidney transplantation is the preferred treatment for patients with end stage renal failure in industrialized countries, but its availability is very limited in Sub-Saharan Africa. In Ethiopia, this option was accessible for only those few who could afford to travel abroad with their living donors for donation and transplantation. In collaboration with faculty from the University of Michigan (UM), the Federal Democratic Republic of Ethiopia, National Kidney Transplant Center, the first Ethiopian kidney transplant program, was launched at Saint Paul’s Hospital Millennium Medical College (SPHMMC) in Addis Ababa in Sept 2015. This study reports on live donor and recipient kidney transplant outcomes to date. Methods This is a retrospective cross sectional qualitative study of live kidney transplant performed at Saint Paul Hospital Millennium Medical College. Results This study reports on live donor and recipient kidney transplant outcomes to date. From September 2015 through February 2018, a total of 70 live kidney transplants were performed at Saint Paul’s Hospital Millennium Medical College (SPHMMC). All procedures were performed by SPHMMC transplant team in collaboration with University of Michigan faculty and later experiences from Hospital Do Rim Sao Paulo Brazil was incorporated. All of recipients were 1st time recipients HLA typing and crossmatch were performed off site B and T cell crossmatch were negative by the CDC method in all patients None of the recipients have significant titer of Anti-HLA antibodies. Majority of donors were females (53.8%) and majority of recipients were males (60%). Donor age ranged from18 to 66 with a mean of 30.2 years. Mostly donors were siblings (40%) or parents (12%) of the recipient. Donor Outcomes 47 were initially hand assisted Laparoscopic nephrectomies (one conversion) with conversion rate of 6.7 % (due to intraperitoneal adhesions ), the remaining twenty three were open donor nephrectomi with after an experience sharing at hospital Do rim in Brazil(a mini-incision (~10 cm) open donor nephrectomy technique has been utilized). There was 100% survival, two re -hospitalization for lymphocele. 1 donor complication – Heamopneumothorax,and Small bowel obstruction requiring exploration, Prolonged hospital stay (14 days) and another with major bleeding during open donor nephrectomy. Recipient Outcome There was only one hyper-acute rejection and four graft censored death one having superficial surgical site infection and one suffering from Atelectasis. Conclusion Despite challenges arising from a resource-limited setting, outcomes of Living Donor Kidney Transplantations (LDKT) performed at SPHMMC are comparable to international standards. Blending experiences from different countries and evolving into a more suitable contextual implimentation of LDKT makes the prospects for sustainable Living Donor Transplantation in Ethiopia are promising. Ethiopian Mistry of Health.

Predictors of Having a Potential Live Donor: A Prospective Cohort Study of Kidney Transplant Candidates

The objective of this study is to analyze the factors that have contributed to the rapid growth of digital marketing on social media, evaluate the importance of digital marketing in the context of social media in the digital age, and identify efficient strategies for implementing digital marketing on social media. The research methodology employed included a quantitative research design with a questionnaire distributed to Generation Z respondents. The data were analyzed using statistical analysis software to assess the efficacy of digital marketing strategies on various social media platforms, including Facebook, Instagram, and TikTok. The findings of the study indicate that Instagram and TikTok are more effective in attracting the attention and engagement of Generation Z than Facebook. Instagram demonstrated the highest level of engagement with visual content, while TikTok exhibited a clear advantage in terms of interactive short video content. The primary factor influencing efficacy is the provision of informative and relevant content aligned with individual interests. The most effective digital marketing strategy entails the use of creative and interactive content on TikTok and Instagram platforms. In conclusion, the results indicate that TikTok and Instagram are more effective than Facebook in attracting the attention of and engaging with Generation Z. The use of visual, interactive, and authentic content is a key factor in the success of digital marketing strategies on these platforms. This study provides guidance for marketers in selecting effective social media platforms and designing digital marketing strategies to reach Generation Z audiences.

Crisis Management in Social Media and Digital Age: Recall Problem and Challenges to Toyota

&lt;p&gt;Social media is widely considered to improve the collaborative learning among students and researchers. However, there is a surprising lack of empirical research in Malaysian higher education to improve performance of students and researchers through the effective use of social media that facilitates desirable outcomes. Thus, this study offers a review of the empirical literature, and its distinctiveness stems from the focus on collaborative learning and engagement in literature, as dominated by higher education. This study also aims to explore factors that contribute to the enhancement of collaborative learning and engagement through social media. It is also unique in that it highlights that the effective use of social media depends on users in what is referred to as social interactivity to "collaborative learning, engagement and intention to use social media" - a phenomenon that relies on the theory of social constructivist learning. The findings showed that collaborative learning, engagement and intention to use social media positively and significantly relate to the interactivity of research group members (students and researchers) with supervisors to improve their academic performance in Malaysian higher education.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Alloimmunization can present a virtually insurmountable barrier to kidney transplantation. Past protocols to desensitize patients using plasmapheresis and cyclophosphamide have not been broadly applied because of the fear of complications, including high rates of immunologic failure. Fifteen patients with a positive donor-recipient cross-match were desensitized with plasmapheresis to permit live donor (LD) transplantation under newer maintenance immunosuppressants. Pretransplant the patients received plasmapheresis three times weekly for a planned maximum of six treatments, plus intravenous hyperimmune globulin, tacrolimus, mycophenolate mofetil, and prednisone. Patients who were successfully desensitized and received transplants were given 10 days of OKT3 postoperatively. Eleven of the 15 patients became anti-human globulin cross-match-negative after one to five plasmapheresis treatments and underwent LD transplantation. Relatively low initial titers of donor-specific antibody were predictive of successful attainment of a negative cross-match. Few side effects and rejection episodes were observed. All transplant patients remain dialysis-free after 3-26 months of follow-up. A positive cross-match is not necessarily a contraindication to LD transplantation, especially for patients with low donor-specific alloantibody titers.

Nowadays, many higher education institutions are still depending on the traditionally-based learning management systems that actually do not use full capabilities of social media in engaging researchers in collaborative learning. Due to recent rise in social media usage, especially among researchers and lecturers of educational institutions, a great deal of research was conducted to explore how to take advantage of social media and use it to improve the researchers ‘academic performance through collaborative learning. To achieve this objective, it is important to explore the actual relationship between two variables: social media and academic performance. This study is aimed at examining the relationship between using social media and improving academic performance. A survey was conducted among the research students of Universiti Teknologi Malaysia, and 323 valid responses were received. Structural equation modeling was employed to test the relationship between three constructs: social media, collaborative learning, and academic performance. The results showed a significant effect of social media on the students’ academic performance with collaborative learning as the mediating variable. Without good collaborative learning, an education institution cannot take advantage of social media for improving academic performance.

Kidney Allograft Fibrosis and Atrophy Early After Living Donor Transplantation

Abstract. Nowadays, the easily accessible nature of the internet is able to reach unlimited audiences. That is why business actors such as coffee shops are starting to use social media to spread information and create awareness of their products or services. One of them is a coffee shop in Bandung City, Cap Dangu. Utilizing visual media content on features on Instagram creates very good impressions and enthusiasm from coffee business people or coffee connoisseurs. Especially at the "Tour De Loa" event, an event showing product casings and visuals about Loa Coffee beans. The aim of this research is to find out and analyze branding strategies and the formation of brand awareness through visual media content at the "Tour De Loa" event on Instagram Coffe Shop Cap Dangu social media. This event was chosen because it was exclusive or was being held for the first time by several coffee activist initiators to be held at Cap Dangu. This event is an urgency for the development of the superiority of West Javanese coffee beans. This research uses a qualitative approach with case studies as the method. Data collection techniques were obtained by interviews, observation and documentation relevant to the research. The research subjects were key informants who were directly involved in the "Tour De Loa" event and Instagram visual media content manager Cap Dangu. The results of the research found that the marketing communication strategy for branding and forming brand awareness through visual content on Cap Dangu's Instagram social media through the Tour De Loa event is through a promotional mix that emphasizes events and experiences gained by consumers as well as public relations and publicity. (Public Relations and Publicity). The visual content focuses on the branding that you want to promote, namely coffee and design. This pattern is visualized in the form of education post and event post content which is aligned with a unified design. Cap Dangu also strengthens its branding with a combination of the color identities of Cap Dangu and Tour De Loa by making the key visual color in the visual content. Abstrak. Dewasa ini, sifat internet yang mudah di akses dapat menjangkau khalayak tanpa batas. Itu sebanya para pelaku usaha seperti kedai kopi mulai memanfaatkan media sosial untuk menyebarkan informasi dan membentuk kesadaran produk atau jasanya. Salah satunya ialah kedai kopi di Kota Bandung, Cap Dangu. Memanfaatkan konten media visual pada fitur di Instagram memunculkan impresi sangat baik dan antusiasme dari para pebisnis kopi atau pun penikmat kopi. Terutama pada event “Tour De Loa”, event show casing produk dan visual mengenai biji Kopi Loa. Tujuan dari penelitian ini, untuk mengetahui dan menganalisis strategi branding dan pembentukan kesadaran merek melalui konten media visual pada event “Tour De Loa” dimedia sosial Instagram Coffe Shop Cap Dangu. Event ini dipilih karena eksklusif atau baru pertama kali dicanangkan oleh beberapa inisiator pegiat kopi yang diselenggarakan di Cap Dangu. Event ini menjadi urgensi untuk perkembangan keunggulan biji kopi khas Jawa Barat. Penelitian ini menggunakan pendekatan kualitatif dengan studi kasus sebagai metode. Teknik pengumpulan data didapat dengan wawancara, observasi dan dokumentasi yang relevan dengan penelitian. Subjek penelitian merupakan key informant yang terlibat langsung dalam acara “Tour De Loa” dan pengelola konten media visual Instagram Cap Dangu. Hasil penelitian ditemukan strategi komunikasi pemasaran untuk branding dan membentuk kesadaran merek melalui konten visual media sosial Instagram Cap Dangu lewat event Tour De Loa adalah dengan melalui bauran promosi yang menonjolkan pada acara dan pengalaman (Events and experiences) yang didapat oleh konsumen serta hubungan masyarakat dan publisitas (Public Relation and Publicity). Adapun konten visual dititik beratkan pada branding yang ingin diusung yaitu coffee and design. Pattern tersebut divisualisasikan dalam bentuk konten education post dan event post yang diselaraskan dengan kesatuan desain. Cap Dangu juga memperkuat branding pada dengan perpaduan identitas warna Cap Dangu dan Tour De Loa dengan menjadikan warna key visual pada konten visual.

Predictors of Kidney Volume Change and Delayed Kidney Function Recovery After Donor Nephrectomy