Donation and Equitable Access to Organ, Tissue, and Cell Transplants: A Brazilian Perspective on the Strategy and Plan of Action 2019-2030.

OBJECTIVE: To position the Brazilian Transplant System within the context of the 4 Strategic Lines of Action proposed by the Pan-American Health Organization. METHOD: A specialist analysis was conducted through comparative analyses of the 4 Strategic Lines of Action, objectives, and indicators outlined in the Action Plan, along with the donation and transplantation system in accordance with Brazilian transplantation law. Subsequent to an in-depth review of the document issued by the health authority, a series of meetings involving 8 specialists in organ donation and transplantation were conducted. During these meetings, discussions were carried out with the objective of numerically interpreting each strategy presented in the document, and recommendations constructed. RESULTS: Four strategies were evaluated and only 2 of them the third (81,3%) and the fourth (90%) do not achieve the indicators to complete the objective related to equitable access to organ, tissue, and cell transplants in Brazil. CONCLUSION: The recommendations developed carry importance, as they are innovative and contribute to the establishment of priorities when shaping public policies. The report not only highlights indicators that were not satisfactorily met but also provides insights into the recommendations formulated to improve those indicators that have already been achieved and to work toward achieving those that have not yet been realized. Additionally, these recommendations can justify actions and establish priorities for research efforts in the field.

Interventions to Improve the Quality in the Organ and Tissue Donation Process.

BACKGROUND: Map Interventions is capable of supporting the multidisciplinary team that works in organ and tissue donation to disseminate quality in this process. METHODS: A scoping review study that was conducted through the steps proposed by the Joanna Briggs Institute. RESULTS: Fifty-six studies made up the sample. 2018 (no. 07, 12.5%) had the highest number of publications. The country that published the most was the United States (no. 16, 28.56%). The database with the most publications was the Cumulative Index to Nursing and Allied Health Literature - CINAHL (no. 15, 26.78%). The most used interventions, which had the most significant impact on the improvement of results and quality, were the use of indicators in all stages of the organ and tissue donation process; the use of real goals that can be achieved; frequent audits, validation of instruments to track opportunities for improvement; as well as methodologies to implement quality and education among professionals who work in this process. Such interventions reveal important changes in the organ donation process, especially in the notification of potential and effective donors, as well as providing an opportunity for safety in the stages of the organ and tissue donation process. CONCLUSION: The interventions tracked suggest the implementation of a set of actions formed by the continuous use of auditing, indicators, continuing education with the team that works in the process of organ and tissue donation, combined with the management of the results obtained through the indicators, where it is generated from these data, actions that have a direct impact on the weaknesses identified.

Patient Undergoing Liver Transplantation: Challenges and Strategies in the Face of the COVID-19 Pandemic.

BACKGROUND: We aimed to identify the challenges and strategies experienced by patients undergoing liver transplantation during the COVID-19 pandemic. METHODS: This was a descriptive study with a qualitative approach conducted in a large liver transplant hospital in southern Brazil. RESULTS: The participants included liver transplant patients between the years 2011 and 2022. Data collection was performed using a semi-structured interview. Data analysis comprised approximation of information and calculation of percentages. RESULTS: A total of 23 patients participated. Challenges identified included an increased dependence on others for daily activities, fear and stress due to the possibility of contamination, and the need for isolation from family and friends. Strategies included adaptation to the daily routine, reorganization of tasks inside and outside the home, formation of a support network, and reduced attendance to consultations and exams. CONCLUSIONS: Evidence of anguish and suffering of patients facing isolation and separation from family members was observed. Still, the study revealed the strength and determination of the patients to create strategies for preventing the SARS-CoV-2 virus and caring for themselves and their families. The study demonstrates the need for support from the health team in the face of such a scenario.

Adverse Events Reporting Systems in Cells, Organs, and Tissues Donation and Transplantation: Scoping Review.

BACKGROUND: This study aimed to map adverse events reporting systems in cells, organs, and tissues donation and transplantation, including the terms applicable in each system and scientific literature. METHODS: This was a scoping review using the Joanna Briggs Institute method. A search strategy in 3 phases was used, and searches were conducted in PubMed, Embase, LILACS, Scholar Google, and government and organ donations and transplantation associations' sites during June and August 2021. Data collection and analysis were independently made by 2 researchers. The scoping review protocol was registered. RESULTS: Twenty-four articles and other materials were selected for data collection. Eleven reporting systems were analyzed, and terms were identified. CONCLUSIONS: Adverse reporting systems in cells, organs, and tissues donation and transplantation were mapped. The main features are presented, which can help develop new and better systems, with an important discussion about the terms used.

Time Elapsed Between Cells, Tissues, and Organs Donation and Transplantation and Adverse Events Detection.

BACKGROUND: This study was designed to discuss the time elapsed between cell, tissue, and organ donation and transplantation and detection of adverse events notified in São Paulo, Brazil. METHODS: This is a descriptive study with a quantitative approach. Data were provided by the Transplant Center of the state of São Paulo from the "Individual notification form of adverse reactions in Biovigilance" between 2016 and 2019. Analysis was performed using descriptive statistics. RESULTS: Fifty-two notifications were analyzed, and 3 categories were formed: (1) adverse events detected on the same day of the transplant, 8; (2) adverse events detected between 1 week and 1.5 years after transplant, 40; and (3) adverse events detected 2 years after transplant, 4. CONCLUSION: The discussion on the topic is beginning; however, it is important. Clinical management of transplant recipients and comprehending what is considered an adverse event and the natural course of a patient's life can impact clinical decision-making, public policies, and patient safety research. This study highlights the need to investigate related factors to adverse events, especially the time between the transplant procedure and adverse event detection, to establish clinical guidelines.

Biovigilância e notificação de eventos adversos na doação e transplante de órgãos: revisão sistemática / Biovigilancia y notificación de eventos adversos en la donación y trasplante de órganos: revisión sistemática / Biosurveillance and reporting of adverse events in organ donation and transplantation: a systematic review

Resumo Objetivo Sintetizar e avaliar criticamente as evidências científicas oriundas de estudos observacionais sobre sistemas de biovigilância e notificação de eventos adversos na doação e transplante de órgãos. Métodos Revisão sistemática de estudos observacionais seguindo as recomendações das Diretrizes Metodológicas (REBRATS) e Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Foram incluídos estudos primários e relatos de caso conduzidos sobre biovigilância e/ou eventos adversos na doação e/ou transplante de órgãos, sem restrição de data de publicação ou idioma. Foram utilizadas seis bases de dados eletrônicas para a realização das buscas na literatura científica: - Medical Literature Analysis and Retrieval System Online (MEDLINE) (via PubMed), Excerpta Medica Database (Embase), Web of Science, LILACS, Scopus e a biblioteca eletrônica Scielo. Realizou-se também busca de dados nas seguintes bases secundárias: Notify - World Health Organization (WHO), Organização Pan-Americana de Saúde (OPAS) e Google Scholar. Para a avaliação da qualidade dos estudos foi utilizada a ferramenta MINORS. Resultados Foram identificados 551 estudos, após as etapas de avaliação, foram incluídos oito deles para a revisão sistemática. Estes foram divididos entre resultados, processos e estratégias de prevenção de eventos adversos. Quanto a classificação da qualidade dos estudos, dois obtiveram classificação boa. Conclusão Os resultados apontam a ocorrência de eventos adversos ocorridos em alguma etapa do processo de doação e transplante de órgãos e tecidos, como: reações adversas relacionadas a medicamentos; neurotoxicidade; aumento do tempo de hospitalização; reintervenções cirúrgicas; queda; coma; óbito; falha ou perda do enxerto. Destaca-se que os eventos adversos possivelmente ainda são subnotificados.

Resumen Objetivo Sintetizar y evaluar críticamente las evidencias científicas provenientes de estudios observacionales sobre sistemas de biovigilancia y notificación de eventos adversos en la donación y trasplante de órganos. Métodos Revisión sistemática de estudios observacionales guiada por las recomendaciones de las Directrices Metodológicas (REBRATS) y Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Se incluyeron estudios primarios y relatos de caso realizados sobre biovigilancia o eventos adversos en la donación o trasplante de órganos, sin restricción de fecha de publicación o idioma. Se utilizaron seis bases de datos electrónicas para realizar las búsquedas en la literatura científica: Medical Literature Analysis and Retrieval System Online (MEDLINE) (via PubMed), Excerpta Medica Database (Embase), Web of Science, LILACS, Scopus y la biblioteca electrónica Scielo. También se realizó la búsqueda de datos en las siguientes bases secundarias: Notify - World Health Organization (WHO), Organización Panamericana de la Salud (OPS) y Google Scholar. Para evaluar la calidad de los estudios se utilizó la herramienta MINORS. Resultados Se identificaron 551 estudios y, luego de las etapas de evaluación, se incluyeron ocho en la revisión sistemática, que fueron divididos entre resultados, procesos y estrategias de prevención de eventos adversos. Respecto a la clasificación de la calidad de los estudios, dos obtuvieron una clasificación buena. Conclusión Los resultados indican casos de eventos adversos ocurridos en alguna etapa del proceso de donación y trasplante de órganos y tejidos, como: reacciones adversas relacionadas con medicamentos, neurotoxicidad, aumento del tiempo de hospitalización, reintervenciones quirúrgicas, caída, coma, fallecimiento, falla o pérdida del injerto. Se destaca que los eventos adversos probablemente aún son subnotificados.

Abstract Objective To synthesize and critically evaluate the scientific evidence from observational studies on biosurveillance systems and adverse event reporting in organ donation and transplantation. Methods Systematic review of observational studies following the recommendations of the Methodological Guidelines (REBRATS) and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Primary studies and case reports on biosurveillance and/or adverse events in organ donation and/or transplantation, without restriction of publication date or language were included. Six electronic databases were used in the scientific literature search: Medical Literature Analysis and Retrieval System Online (MEDLINE) (via PubMed), Excerpta Medica Database (Embase), Web of Science, LILACS, Scopus and the electronic library Scielo. A data search was also performed in the following secondary databases: Notify - World Health Organization (WHO), Pan American Health Organization (PAHO) and Google Scholar. The MINORS tool was used to assess the quality of studies. Results 551 studies were identified, and after the evaluation steps, eight of them were included in the systematic review. These were divided into results, processes and strategies for preventing adverse events. Regarding the classification of the quality of studies, two obtained a good classification. Conclusion The results indicate the occurrence of adverse events at some stage of the organ and tissue donation and transplantation process, such as: adverse drug-related reactions; neurotoxicity; longer length of hospital stay; surgical reinterventions; falls; coma; death; graft failure or loss. The fact that adverse events are possibly still underreported is noteworthy.

Diabetes tipo 2 e transplante renal: estudo comparativo sobre adesão medicamentosa / Diabetes tipo 2 y trasplante renal: estudio comparativo sobre la adhesión farmacológica / Type 2 diabetes and kidney transplant: comparative study on medication adherence

Resumo Objetivo Investigar a adesão medicamentosa no Diabetes Mellitus tipo 2 entre transplantados renais e não transplantados. Métodos Estudo comparativo entre pacientes assistidos no Centro de Diabetes (Grupo 1 sem transplante renal) e no Ambulatório de Pós-Transplante Renal do Hospital do Rim e da Hipertensão (Grupo 2 com transplante renal), ambos na cidade de São Paulo. A amostra foi composta por maiores de 18 anos, com diagnóstico de diabete tipo 2 prévio e em uso de medicamentos para o controle glicêmico. A coleta de dados ocorreu de outubro de 2017 a outubro de 2018. Aplicou-se aos participantes: formulário sócio clínico, instrumento de Medida de Adesão ao Tratamento Medicamentoso no Diabetes Mellitus (antidiabéticos orais e insulina) e a escala de Ansiedade e Depressão. O projeto foi aprovado no Comitê de Ética e Pesquisa como 0712/2017. Resultados Amostra composta de 107 pacientes (Grupo 1: 56 e Grupo 2: 51), maior porcentagem de homens, média de idade de 63,3 anos, provenientes da região metropolitana de São Paulo, aposentados, casados, com sobrepeso, sem sintomas de ansiedade e depressão. Os pacientes autorreferiram ter adesão aos medicamentos para o controle do diabetes, porém os resultados da hemoglobina glicada variaram entre 8,3 e 8,7% entre os grupos, ambos acima de 7%. Conclusão Ao analisar a relação entre a adesão autorreferida, hemoglobina glicada, ansiedade e depressão não foi possível evidenciar correlação estatisticamente significante. Os parâmetros avaliados neste estudo não permitiram estabelecer a relação de causa e efeito.

Resumen Objetivo Investigar la adhesión farmacológica en la Diabetes mellitus tipo 2 en trasplantados renales y no trasplantados. Métodos Estudio comparativo entre pacientes atendidos en el Centro de Diabetes (Grupo 1 sin trasplante renal) y en los Consultorios Externos de Postrasplante Renal del Hospital del Riñón y de la Hipertensión (Grupo 2 con trasplante renal), ambos en la ciudad de São Paulo. La muestra fue formada por mayores de 18 años, con diagnóstico previo de diabetes tipo 2 y en uso de medicamentos para control glucémico. La recopilación de datos se realizó de octubre de 2017 a octubre de 2018. Se aplicaron los siguientes instrumentos a los participantes: formulario socio-clínico, instrumento de Medida de Adhesión al Tratamiento Farmacológico (antidiabéticos orales e insulina) y escala de Ansiedad y Depresión. El proyecto fue aprobado por el Comité de Ética e Investigación con el número 0712/2017. Resultados Muestra formada por 107 pacientes (Grupo 1: 56 y Grupo 2: 51), mayor porcentaje de hombres, promedio de edad 63,3 años, provenientes de la región metropolitana de São Paulo, jubilados, casados, con sobrepeso, sin síntomas de ansiedad y depresión. Los pacientes autodeclararon adherir a los medicamentos para el control de la diabetes, pero los resultados de la hemoglobina glicosilada variaron entre 8,3 y 8,7 % entre los grupos, más de 7 % en ambos. Conclusión Al analizar la relación entre la adhesión autodeclarada, la hemoglobina glicosilada, la ansiedad y la depresión, no se observó correlación estadísticamente significativa. Los parámetros evaluados en este estudio no permitieron establecer una relación de causa y efecto.

Abstract Objective To investigate medication adherence in type 2 Diabetes Mellitus among kidney transplant recipients and non-transplant recipients. Methods Comparative study between patients assisted at the Diabetes Center (Group 1 without kidney transplant) and at the Post-Renal Transplant Outpatient Clinic of the Hospital do Rim e da Hipertensão (Group 2 with kidney transplant), both in the city of São Paulo. The sample consisted of people over 18 years of age with a previous diagnosis of type 2 diabetes using medication for glycemic control. The data collection period was from October 2017 to October 2018. The following was applied to participants: socio-clinical form, instrument for Measuring Adherence to Medication Treatment in Diabetes Mellitus (oral antidiabetics and insulin) and the Anxiety and Depression scale. The project was approved by the Research Ethics Committee as 0712/2017. Results Sample composed of 107 patients (Group 1: 56 and Group 2: 51), higher percentage of men, mean age of 63.3 years, from the metropolitan region of São Paulo, retired, married, overweight, without symptoms of anxiety and depression. Even though patients self-reported adherence to medication for diabetes control, results of glycated hemoglobin ranged between 8.3 and 8.7% between groups, both above 7%. Conclusion When analyzing the relationship between self-reported adherence, glycated hemoglobin, anxiety and depression, a statistically significant correlation could not be found. The parameters evaluated in this study did not allow establishing a cause and effect relationship.

Poder interprofissional em cuidados intensivos: reflexão filosófica a partir de perspectivas foucaultianas e críticas / Poder interprofesional en cuidados intensivos: reflexión filosófica a partir de perspectivas foucaultianas y críticas / Interprofessional Power in Acute Care: Philosophical Reflection using Foucauldian and Critical Perspectives

Resumo Objetivo Discutir as relações de poder entre profissionais de saúde em ambientes de cuidado intensivo e sua interferência no processo de construção do conhecimento. Métodos Neste artigo filosófico, exploramos a influência das relações de poder na construção do conhecimento, a partir das perspectivas foucaultiana e crítica de Gramsci e Freire em relação às práticas de enfermagem e cuidados de saúde. Resultados Há quatro fontes de poder organizacional (tomada de decisão, critério, controle de recursos e controle de conhecimento/rede) que atuam em diferentes níveis das organizações de saúde. As unidades de terapia intensiva são um importante segmento do ambiente de saúde, e a complexidade no cotidiano dos profissionais desse setor pode dificultar as relações de poder no processo de construção do conhecimento. Por exemplo, quando profissionais externos à equipe da UTI, que detêm conhecimentos específicos, precisam ser contatados para auxiliar em casos, como durante o processo de doação e transplante de órgãos. Nesta situação, é necessário desconstruir o poder competitivo para construir o poder colaborativo. Conclusão Usando as perspectivas de Freire e Gramsci, argumentamos que a falta de conhecimento contribui para o poder competitivo, que pode ser superado se os indivíduos envolvidos participarem no processo de aprendizagem em direção ao poder colaborativo. Portanto, as estratégias ou ações para lidar com os desequilíbrios de poder interprofissional podem contribuir para a transformação e mudança mútua.

Resumen Objetivo Discutir las relaciones de poder entre profesionales de salud en ambientes de cuidado intensivo y su interferencia en el proceso de construcción del conocimiento. Métodos En este artículo filosófico, exploramos la influencia de las relaciones de poder en la construcción del conocimiento a partir de las perspectivas foucaultianas y la crítica de Gramsci y de Freire en relación con las prácticas de enfermería y los cuidados de salud. Resultados Hay cuatro fuentes de poder organizativo (toma de decisión, criterio, control de recursos y control de conocimiento/red) que actúan en distintos niveles de las organizaciones de salud. Las unidades de cuidados intensivos son un importante sector del ambiente de la salud, y la complejidad en la labor cotidiana de los profesionales de ese sector puede dificultar las relaciones de poder en el proceso de construcción del conocimiento. Por ejemplo, cuando profesionales externos al equipo de la UCI, que tienen conocimientos específicos, tienen que ser contactados para auxiliar en algunos casos, como durante el proceso de donación y trasplante de órganos. En esta situación se hace necesario deconstruir el poder competitivo para construir el poder colaborativo. Conclusión Usando las perspectivas de Freire y de Gramsci, argumentamos que la falta de conocimiento contribuye para el poder competitivo, que se puede superar si los individuos involucrados participan en el proceso de aprendizaje en dirección al poder colaborativo. Por lo tanto, las estrategias o las acciones para hacer frente a los desequilibrios de poder interprofesional pueden contribuir con la transformación y el cambio mutuo.

Abstract Objective To discuss the power relations among health care professionals in acute care settings and its interference in the process of knowledge building. Methods In this philosophical paper, we explored the influence of power relations on knowledge building using a Foucauldian and critical perspective of Gramsci and Freire related to nursing and health care practices. Results There are four sources of organizational power (decision-making, discretion, control of resources, and control of knowledge/network) that act at different levels of healthcare organizations. Intensive care units are an important segment of healthcare setting, and the complexity involved in the daily activities of professionals in this sector can lead to difficult power relations in the process of knowledge building. For instance, when professionals external to the ICU team that hold specific knowledge need to be contacted to help in cases, such as during organ donation and transplantation process. In this situation it is necessary to deconstruct the competitive power in order to build the collaborative power. Conclusion Using Freire's and Gramsci's perspectives we argued that lack of knowledge contributes to competitive power which can be overcome if involved individuals engage in the learning process towards a collaborative power approach. Therefore, strategies or action to address interprofessional power imbalances can contribute mutual transformation and change.

Good Practices in Transitional Care: continuity of care for patients undergoing liver transplantation.

OBJECTIVES: to develop a guide of care recommendations for good practices in care transition for adult patients undergoing liver transplantation. METHODS: a methodological study, based on the Appraisal of Guidelines for Research & Evaluation in the updated version, II. Care recommendations were sustained by conducting an integrative literature review and qualitative research. RESULTS: from evidence, three topics emerged: Care Transition Planning; Health Education for Self-Care; Care Management. Each of the central topics has respective subtopics, totaling six, giving rise to 30 care recommendations. Concerning evaluators' scores, in all domains the scores were higher than 90%. FINAL CONSIDERATIONS: the proposed guide assists professionals in conducting care transition in liver transplantation, ensuring greater safety for patients in continuity of home care.

Obtaining tissues and organs for transplantation and coronavirus infections: a scoping review.

OBJECTIVES: to map the care recommendations available in the literature capable of supporting health professionals' decision-making in the organ and tissue donation process before the COVID-19 pandemic. METHODS: is a nine-step scoping review with searches performed in three databases and an electronic library (Science Direct). RESULTS: 873 publications were retrieved, 15 selected for analysis. All were published in 2020, originating mainly on China, with predominance of original articles. The most frequent recommendations relate to testing to detect SARS-CoV-2 infection for deceased donors (52.6%) and clinical evaluation of potential donors and possible donors (31.6%). FINAL CONSIDERATIONS: it is believed that the recommendations evidenced will support health professionals in the process of donation and organ transplantations to determine interventions for decision-making during the COVID-19 pandemic.

Obtaining tissues and organs for transplantation and coronavirus infections: a scoping review / Obtención de tejidos y órganos para trasplante e infecciones por coronavirus: revisión de alcance / Obtenção de tecidos e órgãos para transplante e infecções por coronavírus: revisão de escopo

ABSTRACT Objectives: to map the care recommendations available in the literature capable of supporting health professionals' decision-making in the organ and tissue donation process before the COVID-19 pandemic. Methods: is a nine-step scoping review with searches performed in three databases and an electronic library (Science Direct). Results: 873 publications were retrieved, 15 selected for analysis. All were published in 2020, originating mainly on China, with predominance of original articles. The most frequent recommendations relate to testing to detect SARS-CoV-2 infection for deceased donors (52.6%) and clinical evaluation of potential donors and possible donors (31.6%). Final considerations: it is believed that the recommendations evidenced will support health professionals in the process of donation and organ transplantations to determine interventions for decision-making during the COVID-19 pandemic.

RESUMEN Objetivo: mapear las recomendaciones de atención disponibles en la literatura capaces de apoyar la toma de decisiones de los profesionales de la salud que trabajan en el proceso de donación de órganos y tejidos ante la pandemia de COVID-19. Métodos: es una revisión de alcance desarrollada en nueve etapas con búsquedas realizadas en tres bases de datos y una biblioteca electrónica (Science Direct). Resultados: se recuperaron 873 publicaciones, 15 seleccionadas para su análisis. Todos fueron publicados en 2020, originados principalmente en China, con predominio de artículos originales. Las recomendaciones más frecuentes están relacionadas con las pruebas para detectar la infección por SARS-CoV-2 en donantes fallecidos (52,6%) y la evaluación clínica del donante potencial y posible donante (31,6%). Consideraciones finales: se cree que las recomendaciones evidenciadas subsidiarán a los profesionales de la salud que trabajan en el proceso de donación y trasplante de órganos para determinar intervenciones para la toma de decisiones durante la pandemia de COVID-19.

RESUMO Objetivo: mapear as recomendações de cuidados disponíveis na literatura capazes de subsidiar a tomada de decisão de profissionais da saúde atuantes no processo de doação de órgãos e tecidos diante da pandemia de COVID-19. Métodos: trata-se de uma revisão de escopo desenvolvida em nove etapas com buscas realizadas em três bases de dados e uma biblioteca eletrônica (Science Direct). Resultados: foram recuperadas 873 publicações, 15 selecionadas para análise. Todas foram publicadas em 2020, tendo como origem principalmente a China, predominando artigos originais. As recomendações mais frequentes se relacionam com a realização de testes para detectar a infecção por SARS-CoV-2 para doadores falecidos (52,6%) e avaliação clínica do potencial doador e possível doador (31,6%). Considerações finais: acredita-se que as recomendações evidenciadas subsidiarão os profissionais de saúde atuantes no processo de doação e transplantes de órgãos a determinar intervenções para a tomada de decisão durante a pandemia de COVID-19.

Uso terapêutico de tecidos e órgãos humanos para transplantes: eventos adversos e ações de biovigilância / Uso terapéutico de tejidos y órganos humanos para trasplantes: eventos adversos y acciones de biovigilancia / Therapeutic use of human tissues and organs for transplants: adverse events and biovigilance actions

Objetivo: Identificar evidências na literatura sobre eventos adversos e ações de biovigilância no processo de doação e uso terapêutico de tecidos e órgãos humanos para transplante. Método: Revisão integrativa, utilizando as bases de dados LILACS, MEDLINE e Embase. Critérios de inclusão: estudos primários em inglês, espanhol e português, publicados entre 2015 a 2021, acerca da biovigilância na doação e transplante, riscos e eventos adversos. Resultados: Analisados 10 artigos, identificando a ocorrência de eventos adversos referentes ao processo de doação e transplante e estratégias de biovigilância para reduzir riscos e aumentar a segurança. Conclusão: Riscos e eventos adversos podem ocorrer no processo de doação e transplante. Observaram-se estratégias, para mitigar os riscos e a ocorrência/recorrência de eventos adversos, propiciando maior qualidade assistencial e segurança ao paciente. O enfermeiro tem papel fundamental no que concerne à biovigilância, estando presente em todas as fases do processo de doação e transplante(AU)

Purpose: To identify evidence in the literature regarding adverse events and biovigilance actions in the process of donation and therapeutic use of human tissues and organs for transplantation. Method: An integrative review consulting the following databases: LILACS, MEDLINE, and Embase. Inclusion criteria: Primary studies in English, Spanish and Portuguese, published between 2015 and 2021, about biovigilance in the donation and transplants, risks, and adverse events. Results: 10 articles were analyzed, identifying the occurrence of adverse events related to the process of the donation and transplants, biovigilance strategies aiming to reduce risk and increase safety. Conclusion: Risks and adverse events can occur in the process of donation and transplantation. Estrategies were observed to mitigate the risks and occurrence/recurrence of adverse events, providing assistance with greater quality and patient safety. Nurses have a fundamental role with regard to biosurveillance, as they are present in all stages of the donation and transplants(AU)

Objetivo: Identificar evidencias en la literatura sobre efectos adversos y acciones de biovigilancia en el proceso de donación y uso terapéutico de tejidos y órganos humanos para trasplante. Método: Revisión integradora, utilizando las bases de datos LILACS, MEDLINE y Embase. Criterios de inclusión: estudios primarios en inglés, español y portugués, publicados en 2015-2021, sobre biovigilancia en donación y trasplantes, riesgos y eventos adversos. Resultados: Se analizaron 10 artículos, se identificó la ocurrencia de efectos adversos referentes al proceso de donación y trasplante, estrategias de biovigilancia para reducir riesgos y aumentar la seguridad. Conclusión: Riesgos y efectos adversos pueden ocurrir en el proceso de donación y trasplante. Estrategias para mitigar los riesgos y la ocurrencia/recurrencia de efectos adversos, propician asistencia de mayor calidad y seguridad para el paciente. El enfermero tiene un papel fundamental en la biovigilancia, ya que está presente en todas las etapas del proceso de donación y trasplante(AU)

Good Practices in Transitional Care: continuity of care for patients undergoing liver transplantation / Buenas Prácticas en la Atención Transicional: continuidad de la atención de los pacientes sometidos a trasplante de hígado / Boas Práticas no Cuidado Transicional: continuidade da assistência ao paciente submetido ao transplante de fígado

ABSTRACT Objectives: to develop a guide of care recommendations for good practices in care transition for adult patients undergoing liver transplantation. Methods: a methodological study, based on the Appraisal of Guidelines for Research & Evaluation in the updated version, II. Care recommendations were sustained by conducting an integrative literature review and qualitative research. Results: from evidence, three topics emerged: Care Transition Planning; Health Education for Self-Care; Care Management. Each of the central topics has respective subtopics, totaling six, giving rise to 30 care recommendations. Concerning evaluators' scores, in all domains the scores were higher than 90%. Final Considerations: the proposed guide assists professionals in conducting care transition in liver transplantation, ensuring greater safety for patients in continuity of home care.

RESUMEN Objetivos: desarrollar una guía de recomendaciones asistenciales de buenas prácticas en la transición asistencial para pacientes adultos sometidos a trasplante hepático. Métodos: estudio metodológico, utilizando el Appraisal of Guidelines for Research & Evaluation en la versión actualizada, II. Las recomendaciones de atención se sustentaron mediante la realización de una revisión integradora de la literatura y una investigación cualitativa. Resultados: con base en la evidencia, permitió la formación de tres temas: Planificación de la Transición del Cuidado; Educación Sanitaria para el Autocuidado; Administración de Cuidados. Cada uno de los temas centrales tiene subtemas respectivos, totalizando seis, dando lugar a 30 recomendaciones de cuidados. En cuanto a la puntuación de las puntuaciones de los evaluadores, en todos los dominios las puntuaciones fueron superiores al 90%. Consideraciones Finales: la guía propuesta ayuda a los profesionales a realizar la transición de la atención en el trasplante de hígado, garantizando una mayor seguridad para los pacientes en la continuidad de la atención domiciliaria.

RESUMO Objetivos: elaborar um guia de recomendações de cuidados para boas práticas na transição do cuidado de pacientes adultos submetidos ao transplante hepático. Métodos: estudo metodológico, tendo como referencial o Appraisal of Guidelines for Research & Evaluation na versão atualizada, II. Sustentaram-se as recomendações de cuidados por meio da realização de uma revisão integrativa da literatura e uma pesquisa qualitativa. Resultados: a partir das evidências, oportunizou a formação de três tópicos: Planejamento da Transição do Cuidado; Educação em Saúde para o Autocuidado; Gestão dos Cuidados. Cada um dos tópicos centrais apresenta respectivos subtópicos, totalizando seis, originando 30 recomendações de cuidados. No que se refere à pontuação dos escores pelos avaliadores, em todos os domínios os escores foram superiores a 90%. Considerações Finais: o guia proposto auxilia os profissionais na condução da transição do cuidado no transplante hepático, garantindo maior segurança aos pacientes na continuidade do cuidado em domicílio.

Medication non-adherence in heart transplant patients. / Não adesão medicamentosa nos pacientes transplantados cardíacos.

OBJECTIVE: To measure medication non-adherence in patients after heart transplantation using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS) and the Visual Analogue Scale (VAS); to compare the results of biopsies performed with the prevalent comorbidities and survival. METHOD: Quantitative historical cohort. The population consisted of patients undergoing transplantation between 2009 and 2016. RESULTS: Participation of 60 patients. The measurement using the BAASIS was 46.7% of non-adherence and 53.3% of patient adherence. The group with greater difficulty in non-adherence reported up to 2 hours delay of medication intake in relation to the prescribed time (25%), although there was no interruption in medications. The initial diagnosis was Chagas disease (33.3%). The studied comorbidities were systemic arterial hypertension (SAH), diabetes mellitus (DM), dyslipidemia (DLP) and chronic renal failure (CRF). CONCLUSION: Assessment using the BAASIS showed medication non-adherence in 46.7% of heart transplant patients. The VAS according to patients' self-report and nurse's assessment showed high values (93.3% vs 83.3%). The BAASIS tends to address the difficulties reported by patients, when there is a change in doses, delays or anticipations of time and dose.

Validation of the american quality assessment model and performance improvement to the brazilian transplant.

OBJECTIVE: To validate the quality assessment and performance improvement instrument of US transplant programs to the Brazilian reality. METHOD: Methodological study developed for semantic validation and cultural adaptation of the Quality assessment and Performance Improvement instrument in the following steps: 1) translation; 2) synthesis; 3) back translation; 4) review by expert committee; 5) pretest and 6) content validation. To evaluate the agreement between the five judges, the Kappa coefficient was used and for content validation, the content validation index. RESULTS: Kappa coefficient showed the agreement of the judges for semantic, idiomatic, cultural and conceptual equivalences. Content validation index values for relevance and item sequence of at least 0.80 for all blocks. CONCLUSION: The instrument of Quality Evaluation and Performance Improvement of Transplantation Programs proved to be valid and reliable. This instrument will contribute to the development of quality assurance programs for transplant teams in Brazil.