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.

Impact of early ureteric stent removal and cost-benefit analysis in kidney transplant recipients: results of a randomized controlled study.

INTRODUCTION: Duration of retaining ureteric stent in kidney transplantation is still controversial. Our study aimed to compare healthcare expenditures in kidney transplant recipients with early or routine ureteric stent removal. METHODS: This study was a post hoc analysis of data from a single-center parallel randomized controlled open-label study. Ninety patients who underwent kidney transplantation at a university-based hospital in Thailand from April 2010 to January 2011 were enrolled. Patients were randomized to early ureteric stent removal (8 days) or routine ureteric stent removal (15 days) after kidney transplantation. The costs of direct health care associated with kidney transplantation, urologic complication, and urinary tract infection (UTI) within the postoperative period among the 2 groups were compared. RESULTS: Seventy-four patients (58% living donor) fulfilled the randomized criteria (early removal, n = 37; routine removal, n = 37). By intention-to-treat analysis, incidence of UTI in early stent removal was less than the routine stent removal group (15/37, 40.5% vs 27/37, 72.9%; P = .004). Urologic complication showed no significant difference between the early and routine groups (4/37 vs 2/37; P = .39). The cost-benefit analysis of early over routine stent removal was 2390 United States dollars (USD) per patient (11,182 vs 8792 USD). Presence of UTI significantly increase the hospitalization cost of 5131 USD per patient (mean cost = 12,209 vs 7078 USD; P < .001). CONCLUSION: UTI in the early post-kidney transplantation period increases healthcare cost. Early ureteric stent removal can reduce UTI and reduce hospitalization cost. This approach shows cost-benefit in the early management of kidney transplant recipients.