BACKGROUND: Effective interventions during the coronavirus disease 2019 (COVID-19) pandemic require an understanding of patients' knowledge and perceptions that influence their behaviour. Our study assessed knowledge of COVID-19 among kidney transplant recipients and donors, hitherto unevaluated. METHODS: We conducted a cross-sectional survey among 325 kidney transplant recipients and 172 donors between 1 May 2020 and 30 June 2020. The survey questionnaire assessed knowledge levels of COVID-19, sociodemographic data, health status, psychosocial impact of COVID-19 and precautionary behaviours during the pandemic. RESULTS: The mean COVID-19 knowledge score of the study population was 7.5 (standard deviation: 2.2) out of 10. The mean score was significantly higher among kidney recipients compared to kidney donors (7.9 [1.9] vs. 6.7 [2.6]; P <0.001). Younger age (21-49 vs. ≥50 years) and higher education (diploma and higher vs. secondary and lower) were associated with significantly higher knowledge scores in donors, but not among recipients ( P -interactions ≤0.01). In both kidney recipients and donors, financial concerns and/or social isolation were associated with lower knowledge levels. CONCLUSIONS Concerted efforts are needed to improve COVID-19 knowledge in kidney transplant recipients and donors, particularly older donors, donors with lower education and patients with financial concerns or feelings of social isolation. Intensive patient education may mitigate the impact of education levels on COVID-19 knowledge levels.
Humans ; COVID-19/epidemiology* ; Kidney Transplantation ; Middle Aged ; Singapore/epidemiology* ; Male ; Female ; Adult ; Cross-Sectional Studies ; Health Knowledge, Attitudes, Practice ; Transplant Recipients/psychology* ; Surveys and Questionnaires ; Tissue Donors/psychology* ; SARS-CoV-2 ; Young Adult ; Aged ; Pandemics

PURPOSE: The purpose of this study was to assess the effect of quilting suture extent on the latissimus dorsi myocutaneous flap (LDMCF) donor site and the necessity of drainage.METHODS: Clinical data of 136 breast cancer patients, who underwent breast reconstruction using LDMCF between May 2014 and December 2015, were retrospectively reviewed. Patients were divided into three groups. Group A: quilting sutures were performed on half of the LDMCF donor site and a closed suction drain was inserted. Group B: quilting sutures were performed for the entire LDMCF donor site and a closed suction drain was inserted. Group C: quilting sutures were performed for the entire LDMCF donor site and no drain was inserted. The duration of drainage, total drainage, length of hospital stay, number of postoperative aspirations for seroma removal, and total aspirated volume were compared.RESULTS: In the comparison of groups A and B, group B showed better results including the total amount of drained seroma, drain maintenance period, number of aspirations for seroma removal after drainage tube removal, total aspirated seroma, and hospitalization period with statistical significance (P<0.05). In the comparison of groups B and C, group C without drain showed no difference in all other variables except mean total drained seroma volume. Therefore, group C was superior to group A and there was no difference compared to group B with drain, even though the drain was not inserted.CONCLUSION: Total quilting suture at LDMCF donor site can reduce seroma formation and eliminate the need for a drain tube.
Aspirations (Psychology) ; Breast Neoplasms ; Drainage ; Female ; Hospitalization ; Humans ; Length of Stay ; Mammaplasty ; Myocutaneous Flap ; Retrospective Studies ; Seroma ; Suction ; Superficial Back Muscles ; Sutures ; Tissue Donors

PURPOSE: The purpose of this study was to assess the psychosocial status of candidates for deceased donor kidney transplantation (DDKT) in South Korea and identify factors associated with high-risk psychosocial status.METHODS: The descriptive cross-sectional design included application of a standardized transplantation-specific assessment tool, the Psychosocial Assessment Candidacy Transplantation (PACT) instrument, and review of candidates' medical records. A total of 157 patients awaiting DDKT were recruited from a Korean organ transplantation center. The collected data were analyzed using descriptive statistics and binary logistic regression. Candidates were divided into high- and low-psychosocial risk groups using 3 as the cutoff point of PACT.RESULTS: The mean score for the PACT final rating was 2.10, and the lowest average subscale score was 2.30 for understanding the processes of transplantation and follow up. Poor physical candidacy, especially due to comorbidities, and older age were associated with high psychosocial risk.CONCLUSION: The results of this study showed that the psychosocial status of Korean DDKT candidates was problematic. Development of systematic management programs for effective clinical strategies in the care of candidates is crucial to maintain their desirable psychosocial status in case of an emergency DDKT operation and improve post-transplantation outcomes. Continuous education is absolutely necessary to enhance understanding of the transplantation process for high-risk psychosocial candidates. Additionally, nurses and transplantation professionals should screen candidates with high-risk psychosocial status early in the process using transplantation-specific assessment tools and provide intensive interventions, particularly for poor physical candidacy patients and older candidates.
Comorbidity ; Education ; Emergencies ; Follow-Up Studies ; Humans ; Kidney Transplantation ; Kidney ; Korea ; Logistic Models ; Medical Records ; Nursing Assessment ; Organ Transplantation ; Psychology ; Tissue Donors ; Transplants ; Waiting Lists

BACKGROUND: Donor site seroma is the most common complication after latissimus dorsi (LD) flap harvest. This study aimed to evaluate the efficacy of negative-pressure wound therapy (NPWT) in preventing donor site seroma formation after the harvest of an LD flap for breast reconstruction. METHODS: In this prospective matched-pair study, 40 patients in whom an LD flap was harvested for breast reconstruction were enrolled. NPWT was used in 20 patients, and in a control group composed of another 20 patients, the conventional donor site dressing technique was used. Information was collected regarding postoperative complications, the incidence of seroma, total drainage volume, the number of percutaneous seroma aspirations, and the volume aspirated. RESULTS: In the NPWT group, the incidence of seroma formation after drain removal was significantly lower than in the control group (15% vs. 70%; odds ratio=0.07; relative risk, 0.24). Both the mean percutaneous aspirated volume (P=0.004) and the number of percutaneous aspirations (P=0.001) were also significantly lower in the NPWT group. There were no significant differences in the total drainage volume or the duration of wound drainage between the NPWT dressing group and the control group (P>0.05). CONCLUSIONS: This study showed that NPWT is a promising tool for reducing the incidence of seroma formation after removing the drain at the donor site after LD flap harvesting. It is a simple and safe technique.
Aspirations (Psychology) ; Bandages ; Cohort Studies* ; Drainage ; Female ; Humans ; Incidence ; Mammaplasty ; Negative-Pressure Wound Therapy* ; Postoperative Complications ; Prospective Studies ; Seroma* ; Superficial Back Muscles* ; Surgical Flaps ; Tissue Donors* ; Wounds and Injuries

United Nations (UN) adopted 17 global sustainable development agenda to the year 2030 in the 68th general assembly on september, 2015. The global agendas and goals are important for 3 reasons: (1) to adopt the international standard for determining the health status; (2) to identify areas in need of attention; and (3) to advance international cooperation regarding health issues. In the area of infectious diseases, our goals include the eradication of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, and malaria as well as a substantial reduction of hepatitis by the year 2030. In the area of non-communicable diseases, our goal is to reduce premature mortality (< or =70 years) at least 30% by the year 2030. Preventive activities such as smoking cessation, alcohol abstinence, nutritional measures, and physical activities, should also be promoted intensively nationwide. It is also necessary to establish stringent policies for control hypertension, diabetes, obesity, and hypercholesterolemia. Additionally, environmental health, injury by traffic accident, mental health, and drug and alcohol abuse are important health policies. Furthermore, in the area of international health and cooperation, maternal and child health remain important areas of support for underdeveloped countries. Education and training towards the empowerment of health professionals in underdeveloped countries is also an important issue. The global agenda prioritize resources(manpower and budget) allocation of international organizations such as UN, World Health Organization, United Nations Development Programme, and World Bank. The global agenda also sets the contribution levels of Official Developmental Assistance donor countries. Health professionals such as professors and researchers will have to turn their attention to areas of vital international importance, and play an important role in implementation strategies and futhermore guiding global agenda.
Accidents, Traffic ; Acquired Immunodeficiency Syndrome ; Alcohol Abstinence ; Alcoholism ; Child ; Child Health ; Communicable Diseases ; Education ; Environmental Health ; Health Occupations ; Health Policy ; Hepatitis ; HIV ; Humans ; Hypercholesterolemia ; Hypertension ; International Cooperation ; Malaria ; Mental Health ; Mortality, Premature ; Motor Activity ; Natural Resources ; Obesity ; Power (Psychology) ; Smoking Cessation ; Tissue Donors ; Tuberculosis ; United Nations ; World Health Organization

OBJECTIVETo improve the reception and recruitment of sperm donors in sperm banks in China, and solve the problem of insufficiency in sperm donation.

METHODSWe reviewed the recruitment of 1 145 men for sperm donation in the Human Sperm Bank of Hubei Province from September 2011 to April 2012, analyzed the reasons for those not included, and interviewed those included but unwilling to donate sperm.

RESULTSAmong the 1 145 recruits, 551 (48.12%) were students and 594 (51.88%) were other individuals. After the first semen screening, 503 (43.93%) quitted, including 202 students (36.66% of the students recruited) and 301 others (50.67% of the other individuals recruited). After the second semen screening, 432 (37.73%) were excluded, and another 45 (3.93%) excluded after laboratory examination, including 16 cases of mycoplasma positive. Totally, 165 recruits (14.41%) passed the semen screening and laboratory examination, but only 144 of them (87.27%) completed, while the other 21 (12.73%) failed to complete the whole donation process.

CONCLUSIONLow rates of screening qualification and donation process completion are common problems in human sperm banks. The rate of qualified sperm donors can be increased and the operational cost of the human sperm bank can be reduced by enabling the recruits to accomplish the whole donation process. Explanation at the reception, later interview with the recruits, and donors' trust in the sperm bank play important roles in raising the completion rate of sperm donation process.

BACKGROUND: Heart transplantation in elderly patients has raised concerns because of co-morbidities and limited life expectancy in the era of donor shortage. We examined the outcomes after heart transplantation in elderly patients. MATERIALS AND METHODS: From March 1994 to December 2011, 81 patients (male:female=64:17, 49.1+/-14.0 years) underwent heart transplantation. The outcomes after heart transplantation in the younger patients (<60 years; group Y, n=60) were compared with those in the elderly patients (> or =60 years; group O, n=21). The follow-up duration was 51.8+/-62.7 months. RESULTS: Early mortality (< or =30 days) occurred in 5.0% (3/60) and 4.8% (1/21) of groups Y and O, respectively (p>0.999). There were no differences in overall survival between the two groups (p=0.201). Freedom from rejection was higher in group O than in group Y (p=0.026). Multivariable analysis revealed that age > or =60 years was not a significant risk factor for long-term survival; postoperative renal failure was the only significant risk factor for long-term survival (p=0.011). CONCLUSION: Early and mid-term results of heart transplantation in elderly patients were similar to those in younger patients.
Aged ; Follow-Up Studies ; Freedom ; Heart ; Heart Transplantation ; Humans ; Life Expectancy ; Rejection (Psychology) ; Renal Insufficiency ; Risk Factors ; Tissue Donors

The limited donor organ supply is a main problem for transplant surgeons in Korea, and forces them to use organs from extended sources. In one such case, we reused a transplanted kidney allograft in August 2012. This was the first successful case involving the reuse of a transplanted kidney allograft in Korea. The kidney donor was a 44-year-old man brain-dead due to spontaneous subdural hemorrhage. He received a kidney transplant from his sister in 2006. The second recipient was a 59-year-old man who had been receiving hemodialysis for 11 years. There were full human leukocyte antigen (HLA) matches between the first donor and the first recipient, and two HLA mismatches between the first donor and the second recipient. Fortunately, we were able to perform a crossmatch test between the first donor and the second recipient as well as the first recipient and the second recipient (with the first donor's agreement). We used the left iliac artery for perfusion instead of the aorta during organ procurement. The cold ischemic time was 4 hours and the initial kidney function was excellent. The patient has been doing well, without any significant complications or rejections, for 3 weeks. His last serum creatinine level was 0.91 mg/dL. Our case shows that the reuse of kidney allografts could be a possible solution for the shortage of donor kidneys. However, this method requires careful consideration and an agreement among participants before its performance.
Aorta ; Brain Death ; Cold Ischemia ; Creatinine ; Hematoma, Subdural ; Humans ; Iliac Artery ; Kidney ; Kidney Transplantation ; Korea ; Leukocytes ; Perfusion ; Rejection (Psychology) ; Renal Dialysis ; Siblings ; Tissue and Organ Procurement ; Tissue Donors ; Transplantation, Homologous ; Transplants

Progress in the field of antibody mediated rejection (ABMR) in kidney transplantation has shown a rapid increase during the past two decades. New pathologic entities have emerged and replace old concepts and diagnostic terms. According to newly acknowledged facts discovered by clinicians, researchers, and pathologists all over the world, an updated classification, rather than Banff 07, is needed. In order to improve the diagnostic accuracy for ABMR in clinicians as well as pathologists, recognition and awareness of various conditions such as C4d-negative ABMR, subclinical ABMR, de novo donor specific antibody, microcirculation inflammation, isolated vascular lesion, antibody-mediated transplant arteriopathy, etc. are essentially important.
Antibodies ; Complement C4b ; Graft Rejection ; Humans ; Inflammation ; Kidney ; Kidney Transplantation ; Microcirculation ; Peptide Fragments ; Rejection (Psychology) ; Tissue Donors ; Transplants

OBJECTIVE: To measure Irish opinion on a range of assisted human reproduction (AHR) treatments. METHODS: A nationally representative sample of Irish adults (n=1,003) were anonymously sampled by telephone survey. RESULTS: Most participants (77%) agreed that any fertility services offered internationally should also be available in Ireland, although only a small minority of the general Irish population had personal familiarity with AHR or infertility. This sample finds substantial agreement (63%) that the Government of Ireland should introduce legislation covering AHR. The range of support for gamete donation in Ireland ranged from 53% to 83%, depending on how donor privacy and disclosure policies are presented. For example, donation where the donor agrees to be contacted by the child born following donation, and anonymous donation where donor privacy is completely protected by law were supported by 68% and 66%, respectively. The least popular (53%) donor gamete treatment type appeared to be donation where the donor consents to be involved in the future life of any child born as a result of donor fertility treatment. Respondents in social class ABC1 (58%), age 18 to 24 (62%), age 25 to 34 (60%), or without children (61%) were more likely to favour this donor treatment policy in our sample. CONCLUSION: This is the first nationwide assessment of Irish public opinion on the advanced reproductive technologies since 2005. Access to a wide range of AHR treatment was supported by all subgroups studied. Public opinion concerning specific types of AHR treatment varied, yet general support for the need for national AHR legislation was reported by 63% of this national sample. Contemporary views on AHR remain largely consistent with the Commission for Assisted Human Reproduction recommendations from 2005, although further research is needed to clarify exactly how popular opinion on these issues has changed. It appears that legislation allowing for the full range of donation options (and not mandating disclosure of donor identity at a stipulated age) would better align with current Irish public opinion.
Adult ; Anonyms and Pseudonyms ; Child ; Surveys and Questionnaires ; Disclosure ; Fertility ; Fertilization in Vitro ; Humans* ; Infertility ; Ireland ; Jurisprudence ; Privacy ; Public Opinion* ; Public Policy ; Recognition (Psychology) ; Reproduction* ; Reproductive Techniques ; Social Class ; Telephone ; Tissue Donors