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Abstract
Background
Health maintenance and monitoring of transplant candidates, the great majority of whom are undergoing chronic dialysis, can be a determinant of post-transplant prognosis. New issues such as malignancy, inflammation, cardiovascular disease, and psychosocial problems might arise among potential recipients, which may lead to cancellation of the transplantation.
Methods
A questionnaire, including questions regarding follow-up monitoring, was sent to 66 transplant centers, and responses to the survey were obtained from 35 centers (53%). A similar questionnaire was sent to 217 wait-listed patients, and 164 (76%) responded.
Results
Regular contact between the transplant center and patients was maintained by only 37% of the centers. No consistent pattern of contact was observed for 11%. Sixty percent of the centers monitored patients by telephone. Three-fourths of the transplant centers monitored their patients annually or every 6 months. A cancer screening program was run by only 17% of the centers, and 29% did not routinely request cardiac screening. Most centers (83%) informed their patients of the features of marginal kidneys. However, many patients (69%) reported not hearing about marginal kidneys, and 43% indicated that a cadaver transplant was cancelled because of a cadaver donor problem.
Conclusions
Our survey indicates that the necessity for routine follow-up monitoring is broadly recognized by 86% of transplant centers and 78% of wait-listed patients However, no formal monitoring guidelines currently exist for wait-listed patients in Korea. Therefore, guidelines are absolutely necessary for improving the quality of post-transplant life.
References
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Fig. 1.
Contact pattern and method of transplantation centers to patients on the waiting list. (A) % regular contact. (B) Method of contact. (C) Frequency of contact reported by transplantation centers. (D) Frequency of contact reported by patients.
Fig. 3.
Screening for cardiovascular disease. (A) The subject of screening. (B) Screening methods. Abbreviations: CVA, cerebral vascular accident; DM, diabetes mellitus; MIBI, myocardial spect.
Table 1.
Survey questions and responses a for Transplantation Centers
Table 2.
Survey questions and responses a for waiting-listed patients
Table 3.
Characteristics of transplantation centers included in this survey
| Total number of centers | 66 |
|---|---|
| Number of centers responded to the survey | 35 (53%) |
| Number of patients on the waiting list | |
| ＜100 | 19 (54%) |
| 100∼500 | 13 (37%) |
| ＞500 | 3 (9%) |
Table 4.
Proposed program for managing waitlisted patients
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