Effectiveness of Multimedia for Transplant Preparation for Kidney Transplant Waiting List Patients.

BACKGROUND: A multimedia program could effectively advise patients about preparing for transplantation while on the waiting list for a kidney transplant. This study aimed to compare knowledge about transplant preparation for patients on a kidney transplant waiting list before and after participating in a multimedia program, and to evaluate patient satisfaction with the multimedia program. METHODS: Research design was quasiexperimental with the use of 1 group. Subjects were 186 patients on the kidney transplant waiting list after HLA matching in Ramathibodi Hospital. The questionnaires were developed by the researchers. The statistical tools used were basic statistics, percentage, average, standard deviation, and the difference of score between before and after participation in the multimedia program (t test). RESULTS: The evaluation knowledge for transplant preparation for kidney transplant waiting list patients after participating in the multimedia program averaged 85.40%, and there was an increased improvement of score by an average 3.27 out of a possible full score of 20 (P < .05). The result of patient satisfaction for the multimedia program had good average, 4.58.

Assessment of the Changes in Health-related Quality of Life After Kidney Transplantation in a Cohort of 232 Thai Patients.

AIM: The aim of this study was to investigate QoL of these patients before and after KT and to determine relationships between basic factors of gender, age, educational background, marital status, income, and QoL of patients after undergoing KT. METHODS: A retrospective study to determine HQoL of 232 ESRD patients who received KT in a single center in Thailand. HQoL was determined by 3 methods: WHO questionnaires, EQ5D questionnaires, and visual analog scale (VAS) questionnaires. Other important demographic information including gender, age, education, marital status, and family income were recorded. Pre- and post-KT HQoL was scored and compared. The Pearson method was used to calculate correlation statistics. RESULTS: WHO QoL is significantly improved in all domains including physical health, psychological health, social health, and environmental health after KT (P < .001). EQ5D QoL is also significantly improved after KT for the categories of self-mobility, self-care, pain, distress, anxiety, and depression. The mean score of VAS before KT was 40.98 and rose to 83.10 after KT (P < .001). Gender and marital status were not significantly correlated with quality of life. The level of education and average income of the family are positively correlated with increased QoL after KT (P < .01 and P < .001). However, age is negatively correlated with increased QoL (P < .05). CONCLUSION: Successful KT leads to a significant increase of HQoL as determined by 3 independent measurements. The improvement is shown by better physical health, psychosocial health, environmental health, and functional abilities of the transplant recipients. Our results confirm that KT should be the treatment of choice for patients with ESRD.

Adenovirus infection after kidney transplantation in Thailand: seasonal distribution and potential route of acquisition.

BACKGROUND: Data on the epidemiology and route of acquisition of adenovirus (ADV) infection after kidney transplantation are limited. From April 2007 to March 2010, there were 17 cases of ADV infection: namely, 2 from April to December 2007; 8 from January to December 2008; 4 from January to December 2009; and 3 from January to March 2010. Most cases occurred in October and November (n = 8; 47.1%), followed by February to April (n = 6; 35.3%) and July (n = 3; 17.6%). METHODS: From April 2007 to August 2009, the diagnosis of ADV infection was made based on patient symptoms. From September 2009 to March 2010, in addition to symptoms, the diagnosis was complemented by urine surveillance for ADV using real-time polymerase chain reaction (PCR) prospectively performed every 1-2 weeks among recipients of living-related kidney, starting at week 2 posttransplantation for a total of 8-12 weeks. Before transplantation, recipients and donors were screened for ADV in urine and also using nasal swab. RESULTS: Only 1 of the 24 patients displayed a positive ADV PCR in the urine surveillance study. A local investigation during a cluster of cases in October 2008 showed 2 patients who developed ADV after sharing a room in the transplant unit. Although nosocomial transmission was probable, the majority of cases were scattered over time rather than clustering in 1 time period. CONCLUSION: These findings suggested that ADV infection cases occurred after exogenous exposure. In a resource-limited country, early diagnosis of ADV is justified for patients with compatible symptoms complemented by intense infection control to prevent nosocomial transmission from a confirmed case.