Technologies During the COVID-19 Pandemic: Teleconsultation in Care Management for Patients Undergoing Liver Transplant.

BACKGROUND: The aim of this study was to identify home care management strategies for patients undergoing liver transplant, through teleconsultation, during the COVID-19 pandemic for maintenance and improvements in treatment adherence. METHODS: This was a qualitative, exploratory, and descriptive research study. Participants included patients who underwent liver transplant between 2020 and 2021. Through a semistructured script, data were analyzed according to the recommendations of content analysis and then simple statistics were applied. RESULTS: Twenty-two people participated in the study. Two analysis categories were developed, which resulted in 7 strategies and 22 care actions. The care strategy with the highest adherence involved actions related to the prevention of COVID-19. CONCLUSIONS: Teleconsultation is an excellent tool to manage and supervise post-liver transplant care of patients. Considering that teleconsultation has presented strategies and care actions, which were developed by the patients, the patients have a direct effect on treatment adherence despite pandemic impositions.

Complications Following Liver Transplant at a Teaching Hospital.

OBJECTIVE: The objective of this study is to analyze the liver transplant complications in a reference transplant hospital in southern Brazil. METHODS: The researchers used a cross-sectional, quantitative, exploratory, and descriptive study, conducted using 103 medical records of patients who underwent liver transplantation from 2011 to 2018. Data were analyzed through median, mean, and standard deviation, and the Kruskal-Wallis test was used. RESULTS: There was a higher proportion of men (70.9%), with a mean age of 53.3 years, who had hepatitis C (43.7%). The indication for the procedure was hepatocellular carcinoma (34%). The most frequent complications included pulmonary (26.7%), graft-related complications such as rejection (21.1%), and viral infections (14.4%). In addition, infectious complications, such as pneumonia (45%) and septicemia (29%), occurred. The main causes of death were septic shock (15.6%) and multiple organ failure (21.9%). There was statistical significance between the recipient's age and the Model for End-Stage Liver Disease value at the time of transplantation for the development of complications. CONCLUSIONS: The data from the present study provide important information about liver transplant. These data may enable the team to propose strategies for practice improvements, which will certainly offer better living conditions and transplant survival.

Health Needs of Patients Undergoing Liver Transplant From the Context of Hospital Discharge.

OBJECTIVE: To identify the health needs of the patient and family facing the perspectives of discharge, health care, and adaptation to the new reality at home. METHODS: This was a quantitative and qualitative, exploratory, descriptive study conducted at a reference hospital for liver transplantation. The participants were patients undergoing liver transplant in this hospital unit from 2011 to June 2019. A semistructured interview script was used for data collection, and data were analyzed according to guidelines proposed for content analysis. RESULTS: Twenty patients participated, with a mean age of 40.2 years; 76% were men. The interview data enabled the development of 3 categories: daily health care, warning signs, and adaptation to the new health care routine. The data obtained from the categories showed that the main health needs include difficulties in blood glucose management, insulin administration, the importance of awareness of the warning signs, and obtaining support from the health care team to deal with food restrictions and high doses of medication. CONCLUSION: The health needs are focused on identifying strategies to develop daily care, in addition to seeking better strategies to adapt to the new reality. The study showed the need for individualized discharge planning by the health care team, based on the health needs of each patient.