| 1. |
- Hagelin, Joakim, et al.
(författare)
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Religious beliefs and opinions on clinical xenotransplantation : a survey of university students from Kenya, Sweden and Texas
- 2001
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Ingår i: Clinical Transplantation. - : Wiley. - 0902-0063 .- 1399-0012. ; 15:6, s. 421-425
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the association between religious beliefs and opinions on xenotransplantation among students from three different countries. A lower proportion of religious students accepted xenotransplantation than did non-religious students. A higher proportion of Protestant students seemed to accept xenotransplantation than did Muslim and Roman Catholic students. A higher proportion of the religious respondents had not formed an opinion on xenotransplantation compared to non-religious students. There was no difference according to gender on views on xenotransplantation, but a higher proportion of older students seemed to accept xenotransplantation than did younger students. A higher proportion of non-vegetarians reported acceptance of xenotransplantation than did vegetarians. Acceptance of xenotransplantation was higher in Sweden compared to the two other regions, and the proportion of students who had formed an opinion was higher as well.
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| 2. |
- Hagelin, Joakim, et al.
(författare)
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Students' acceptance of clinical xenotransplantation
- 2000
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Ingår i: Clinical Transplantation. - : Wiley. - 0902-0063 .- 1399-0012. ; 14:3, s. 252-256
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to elucidate undergraduate university students' views on clinical xenotransplantation. A total of 1875 students From eight faculties at Uppsala University and the Swedish University of Agricultural Sciences answered a questionnaire. Three out of four respondents would be prepared to receive a transplant from an animal on medical grounds if necessary. Forty percent had signed an organ donation card. There was no difference in attitude between those who had signed an allotransplantation card and those who had not. According to gender, age, length of university program, and faculty, results showed that a higher proportion of those who approved were male, young, and studying on programs longer than three years; also, they were more likely to study programs in the Faculties of Agriculture and Pharmacy. At the Medical Faculty, nursing studentsseemed to be less approving, compared to future biomedical analysts, biomedical scientists, and physicians. The acceptance of xenotransplantation also tended to be positively associated with morally accepting and understanding the use of animals in biomedical research, the approval of euthanasia, the approval of early abortion, and the use of human fetuses in research, as well as clinical testing of humans.
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| 3. |
- Haljamäe, Ulla, et al.
(författare)
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Remaining experiences of living kidney donors more than 3 yr after early recipient graft loss
- 2003
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Ingår i: Clinical Transplantation. - : John Wiley & Sons. - 0902-0063 .- 1399-0012. ; 17:6, s. 503-510
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Tidskriftsartikel (refereegranskat)abstract
- Living kidney donor programs, based on willingness among family members and close relatives to donate, have made it possible to perform a satisfactory number of kidney transplantations. Early graft loss in the recipient may occur and it is not known if such an event will result mainly in acute, rather transient, emotional reactions or if long-lasting reactions may be evoked in the living kidney donor. The aim of the present study was to assess and describe the remaining experiences of donors (n = 10) more than 3 yr after early recipient graft loss or death of the recipient. A phenomenographic, interview-based research approach was used. Five different fields or domains were identified: (i) the decision to donate; (ii) the information provided; (iii) care received at the time of donation; (iv) responses at graft failure; and (v) concerns remaining at the time of the interview. All donors expressed that they had volunteered to donate and that no stress had been put on them. The information given prior to and in connection with the donation procedure was deemed insufficient but all donors were satisfied with the medical care provided in connection with the nephrectomy and in the immediate post-operative period. Graft failure was immediately accepted on the intellectual level by nine of 10 donors but still evoked emotional reactions and responses included a wish that continuing contact with the transplant staff had been provided. The present interview-based study shows that it is of importance that the donor is thoroughly informed about all donor as well as recipient-related factors including the potential risk of recipient graft failure. In case of graft failure, or the death of the recipient, the transplant unit staff members should offer contact for discussions of medical matters as well as for psychosocial support. In individual cases it may be necessary to maintain such a supportive contact channel for a prolonged period of time.
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| 4. |
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| 5. |
- Nordén, Gunnela, 1945, et al.
(författare)
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Macrovascular disease after simultaneous pancreas and kidney transplantation.
- 2004
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Ingår i: Clinical transplantation. - : Wiley. - 0902-0063 .- 1399-0012. ; 18:4, s. 372-6
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to evaluate the outcome of simultaneous pancreas and kidney transplantation (SPK) with focus on cardiovascular mortality and morbidity in relation to graft function. From January 1985 through 1999, 87 SPK were performed in the unit. Sixty recipients were males, median age at diabetes onset 13 yr (1-40) and age at transplantation 39 yr (29-54). No case was lost to follow-up. Morbidity and mortality during median 8 yr of follow-up (range 1-15 yr) were recorded. Major macrovascular disease (MVD) was defined as myocardial infarction or sudden death (AMI), stroke or peripheral gangrene requiring amputation of leg, foot or fingers. At the evaluation, 26 of 87 patients (30%) had died, 19 after loss of the pancreas graft and 20 after loss of the kidney. MVD was the dominant cause of death. Non-lethal MVD had previously been recorded in 62%. Of the 61 patients alive, 22 had lost their pancreas graft and 12 the concomitant kidney. MVD had occurred in 32%. Whereas 89% of the concomitant kidneys functioned when the pancreas graft did so, only 37% of the kidneys functioned if the pancreas had been lost, p < 0.0001. The mortality rate was significantly higher among patients who lost both grafts (16/26) than in those who lost only the pancreas graft (3/15), p = 0.01. Progressive MVD is a major clinical problem for SPK transplant patients, particularly if the kidney fails.
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| 6. |
- Sanner, Margareta A.
(författare)
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Transplant recipients' conceptions of three key phenomena intransplantation : the organ donation, the organ donor and the organ transplant.
- 2003
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Ingår i: Clinical Transplantation. - : Wiley. - 0902-0063 .- 1399-0012. ; 17:4, s. 391-400
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Tidskriftsartikel (refereegranskat)abstract
- Thirty-five heart and kidney transplant patients were interviewed on five separate occasions during the first 2 yr after transplantation. The aim was to explore their experiences of phenomena that distinguish the transplantation from other kinds of medical treatment. The selection of informants was designed to permit comparisons between recipients with heart and kidney transplants and with living and necro-transplants. The qualitative analysis of the informants' reactions was focused on three themes; nine categories emerged. The first theme concerned general aspects of the donation and the donor and was differentiated in four categories: joy and sorrow, gratefulness and indebtedness, guilt, and inequity. The second theme related to the donor as a unique individual and included three categories: recognition and identification with the donor, influences of the donor, and relationship to the living donor. The third theme pertained to incorporation of the transplant and included two categories related to the naturalness of having a transplant, and the benevolent transplant. The informants' reactions were discussed in terms of primary and secondary processes. All informants were in an emotionally charged situation after transplantation and warded off anxiety-provoking impulses, most intensively during the first 6 months. Avoidance, suppression, and denial were the most common defence mechanisms, all of which seemed to be supported by the medical context. Other, more constructive strategies are suggested. The recipients' own interpretations of causes to possible personality changes are discussed. There were few differences between heart and necro-kidney patients concerning the reactions to the donation, the donor, and the transplant; the dividing line was more prominent between recipients with living and necro-transplants.
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| 7. |
- Sanner, Margareta
(författare)
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People's feelings and ideas about receiving transplants of different origins : questions of life and death, identity, and nature's border
- 2001
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Ingår i: Clinical Transplantation. - : Wiley. - 0902-0063 .- 1399-0012. ; 15:1, s. 19-27
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the public's feelings and ideas with regard to receiving transplants of different origins. Sixty-nine individuals with varying sociodemographic background, selected from samples who had responded to a questionnaire on receiving and donating organs, were interviewed in-depth. A wide variety of reactions was displayed. The feelings and ideas about receiving organs were summarized in ten categories: 1) the emergency situation; 2) the functioning of the transplant; 3) the influence of transplants on personality, behaviour, and appearance; 4) the influence of transplants on body image; 5) disgust; 6) cannibalism; 7) trespassing nature's border; 8) tradition; 9) ethical considerations; and 10) the debt of gratitude. Most individuals were willing to accept at least one organ. Animal organs were the least preferred. The hierarchy of organ preferences – with organs from a relative at the top and animal organs at the bottom – was explained in terms of rational, magical, and analogy thinking. Finally, the consequences for the encounter between health care personnel and transplantation candidates were briefly discussed.
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| 8. |
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| 9. |
- Silverborn, Martin, 1969, et al.
(författare)
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Increased arterial stiffness in cyclosporine-treated lung transplant recipients early after transplantation
- 2004
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Ingår i: Clin Transplant. - : Wiley. - 0902-0063. ; 18:4, s. 473-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The majority of patients undergoing solid organ transplantation develop hypertension, to which cyclosporine (CsA)-induced peripheral vasoconstriction may contribute. We hypothesized that CsA-treated transplant recipients have an increased basal vascular tone and an altered response to nitric oxide. To test this hypothesis arterial resistance, non-endothelial dependent relaxation and arterial stiffness were investigated in CsA-treated lung transplant recipients within 18 months after transplantation. METHODS: In study 1, forearm blood flow (FBF) was measured by venous occlusion plethysmography at baseline and during glyceryl trinitrate (GTN) and N(G)-monomethyl-l-arginine acetate (l-NMMA) infusion in seven lung transplant recipients and nine healthy subjects. In study 2, arterial stiffness in carotid (CCA) and radial artery (RA) was measured by ultrasound (echo-tracking) in 10 lung transplant recipients, 12 healthy subjects and six patients waiting for lung transplantation. RESULTS: Basal FBF (3.1 +/- 0.2 vs. 3.0 +/- 0.3 mL/min, p = 0.79) and forearm arterial resistance (36 +/- 3 vs. 33 +/- 3 mmHg/mL/min, p = 0.60) did not differ between transplant recipients and controls. GTN infusion increased and l-NMMA decreased blood flow equally in both groups. Transplant recipients had increased arterial stiffness compared to both pre-transplant patients and healthy subjects (CCA stiffness index 11.7 +/- 1.1 vs. 8.5 +/- 0.2 and 8.6 +/- 0.6, p < 0.05 both; RA stiffness index 14.7 +/- 1.5 vs. 8.9 +/- 1.3 and 10.6 +/- 0.7, p < 0.05 both). CONCLUSIONS: Forearm blood flow and arterial resistance did not differ between healthy subjects and cyclosporine-treated lung transplant recipients early after transplantation. Increased arterial stiffness was demonstrated in transplant recipients, which may have implications for future development of transplant hypertension.
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