Gozdowska J, Zatorski M, Torchalla P, Białek Ł, Bojanowska A, Tomaszek A, Serwańska-Świętek M, Kieszek R, Kwiatkowski A, Chmura A, Durlik M
Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
University of Social Sciences and Humanities, Poznań, Poland.
Transplant Proc. 2016 Jun;48(5):1498-505. doi: 10.1016/j.transproceed.2016.01.075.
Health benefits of a living-donor kidney transplantation are numerous and well known. There is, however, a dearth of knowledge on postoperative quality of life among the living-donor (LD) compared to deceased-donor (DD) transplant recipients.
The study involved 89 patients after renal transplantation: 48 from LDs and 41 from DDs. Interview data indirectly indicated the patients' health, whereas physiological parameters directly pinpointed the patients' health and the graft function. All study participants completed questionnaires to measure quality of life and the specificity of emotional and cognitive functioning.
LD kidney recipients were younger than DD recipients (40 years vs. 49 years). LD and DD transplantation patients were similar in health status assessed by indirect methods (data from an interview) and direct methods (laboratory tests results). They, however, differed in their psychosocial functioning. LD patients had a greater sense of happiness (P < .01) and of self-efficacy (P = .07). Moreover, these patients were more actively involved in their social lives (P < .02) and were more satisfied with their social relationships (P = .07). LD recipients also had a higher quality of life in terms of mental functioning (P < .01) and satisfaction with their environments (P < .01). Additionally, there were significant correlations between quality of life and the quality of cognitive and emotional functioning in the group of LD recipients. The perceived impact of health on physical and professional activity and daily routines was similar in LD and DD groups.
LD post-transplantation patients may derive greater psychosocial benefits from this form of treatment. This effect is not dependent on somatic parameters (comparable data from an interview and laboratory tests results). This study suggests that patients should be assisted by a multidisciplinary healthcare team, and receive continuous support from relatives during the post-transplantation adaptation process. This facilitates the patients' postoperative quality of life.
活体供肾移植对健康有益,这一点众所周知且益处众多。然而,与尸体供肾(DD)移植受者相比,关于活体供肾(LD)移植受者术后生活质量的了解却很少。
该研究纳入了89例肾移植术后患者:48例来自活体供肾者,41例来自尸体供肾者。访谈数据间接反映患者的健康状况,而生理参数则直接表明患者的健康状况和移植肾功能。所有研究参与者均完成了用于测量生活质量以及情绪和认知功能特异性的问卷。
活体供肾肾移植受者比尸体供肾移植受者年轻(40岁对49岁)。通过间接方法(访谈数据)和直接方法(实验室检查结果)评估,活体供肾和尸体供肾移植患者的健康状况相似。然而,他们的心理社会功能存在差异。活体供肾患者有更强的幸福感(P <.01)和自我效能感(P =.07)。此外,这些患者更积极地参与社交生活(P <.02),对社会关系更满意(P =.07)。活体供肾移植受者在心理功能(P <.01)和对环境的满意度(P <.01)方面也有更高的生活质量。此外,在活体供肾移植受者组中,生活质量与认知和情绪功能质量之间存在显著相关性。健康对身体和职业活动以及日常生活的感知影响在活体供肾组和尸体供肾组中相似。
活体供肾移植术后患者可能从这种治疗形式中获得更大的心理社会效益。这种效果不依赖于躯体参数(访谈和实验室检查结果的可比数据)。这项研究表明,患者在移植后适应过程中应得到多学科医疗团队的协助,并得到亲属的持续支持。这有助于提高患者术后的生活质量。