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A qualitative research on postoperative psychological experiences of patients who received kidney transplantation donated by his/her parents

SUN Sheng-hong;LIU An-nuo;JIN Zong-lan;SHEN Zhen;LIU Hong-yan;GONG Juan;WANG Lu-lu

Chinese Journal of Nursing,2017,Vol 52,No. 04

【Abstract】 Objective To investigate the postoperative psychological experiences of patients who underwent kidney transplant donated by his/her parent, and to discover mental signs and psychological journey in individual growth. Methods Semi-structured in-depth interviews were conducted among 17 patients who underwent kidney transplant donated by his/her parent, and Giorgi analysis method was used to analyze data. Results The postoperative psychological experiences of patients mainly contained four aspects: post traumatic growth, rebuilding meaning of life, being grateful for experience, coexisting of hope and challenge. Conclusion The patients have complex psychological experiences, having positive aspects derived from rehabilitation and improved quality of life, as well as negative aspects derived from concerning health of the donor, fear for complication and rejection, and lack of sound supporting system. Medical staff should guide patients to adjust cognitive and behavioral patterns and face life events directly, integrate medical/social support resources and enhance patients’ psychological capital to face future life.

Study on the influencing factors of gratitude in recipients underwent living kidney transplant from family member

SUN Shenghong;LIU Annuo;LI Lunlan;JIN Zonglan;ZHANG Ling;LIU Hongyan;WANG Lulu;GONG Juan

Chinese Journal of Nursing,2018,Vol 53,No. 07

【Abstract】 Objective To understand the level of gratitude, post-traumatic growth, and social support in kidney transplant recipients from family member, to explore the influencing factors of gratitude and its relationship with post-traumatic growth and social support, and to guide patients to take gratitude into self-management with subjective initiative from patients in long-term follow-up after the operation. Methods Questionnaire survey was conducted in recipients underwent living kidney transplant from family member who were regularly followed up in our hospital from January, 2017 to August, 2017, using self-designed general information questionnaire, Gratitude Questionnaire-6, Post-traumatic Growth Inventory and Social Support Rating Scale. Results The total score of gratitude, post-traumatic growth, and social support of kidney transplant recipients was (30.01 ± 3.13), (63.10 ± 8.82), and (41.74 ± 5.10), respectively. Patient’s gratitude was significantly positively correlated with the total score of post-traumatic growth and social support ( P < 0.01). The results of one-way ANOVA showed that the factors influencing gratitude of kidney transplant recipients were gender, educational level, occupation and medical insurance type. Multivariate analysis showed that the influencing factors were gender, occupation, medical insurance type and social support. Conclusion Positive guidance and perfect social support system are beneficial to raising the level of gratitude in kidney transplant recipients, improve patient’s physiological, psychological and social functions, and promote postoperative psychological resilience and quality of life.

Pharmacokinetics Study of Mycophenolic Acid in Early Renal Transplant Patients

LUO Yong-gang;ZHU Zhen-feng;SUN Zhi;LI Zhuo-lun;SHI Ying-ying;LIU Li-wei;ZHANG Jun;ZHANG Xiao-jian

Chinese Pharmaceutical Journal,2018,Vol 53,No. 18

【Abstract】 OBJECTIVE To investigate the pharmacokinetic characteristics of enteric-coated sodium mycophenolate (EC-MPS) or mycophenolate mofetil (MMF) dispersible tablets after multiple oral doses in early renal transplant patients, providing references for the rational use of the study drugs in clinical practice. METHODS Thirty-eight first-time renal transplant patients were selected and randomly divided into EC-MPS group ( n = 18) or MMF dispersible tablets group ( n = 19). The patients received EC-MPS (540 mg, q12 h) or MMF dispersible tablets (750 mg, q12 h), combined with tacrolimus and methylprednisolone to prevent acute rejection, respectively. Blood samples were collected at pre-dose, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12 h after oral administration on the postoperative day 5. Enzyme multiplied immunoassay technique (EMIT) was employed to determine the plasma concentration of MPA. The main pharmacokinetic parameters of the two drugs were assessed. RESULTS Pharmacokinetic parameters on the postoperative day 5 of EC-MPS and MMF dispersible tablet were as follows: AUC 0–12 h were (43.62 ± 16.20) and (42.02 ± 14.40) mg·h·L −1 ( P > 0.05); ρmax were (17.85 ± 11.32) and (13.96 ± 5.11) mg·L −1 ( P > 0.05); tmax were (2.72 ± 1.74) and (1.32 ± 0.42) h ( P < 0.05); ρ0 were (1.63 ± 1.18) and (1.66 ± 0.93) mg·L −1 ( P > 0.05); ρ12 were (1.84 ± 2.09) and (1.81 ± 1.76) mg·L −1 ( P > 0.05); CL were (14.12 ± 5.30) and (19.66 ± 5.99) L·h −1 ( P < 0.05). Most of the patients revealed a second small peak in the 4–12 h after taking MPA in the two study groups. CONCLUSION There are large individual differences of pharmacokinetic between EC-MPS and MMF dispersible tablets in early renal transplant patients. It is necessary to carry out therapeutic drug monitoring of MPA to guide the adjustment of drug dosage.

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