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S 16 Parallel Session
Programme of the Session
Title: Transplantation
GS: Federico Oppenheimer (Spain)
Changing peoples attitudes to become donors- difficulties and challenges
O 28
Live kidney donation Aotearoa – a New Zealand solution
Denise Beechey (New Zealand)
O 29
Impact of an organ donation initiative – teamworking across the NHS, charities & communities
Neerja Jain (UK)
O 30
Psychosocial experiences of kidney transplant patients before and after transplantation
Emine Selda Gunduz (Turkey)
O 31
Why don’t we donate? – Nurses’ and midwives’ attitudes towards transplantation
Anna Kliś (Poland)
Abstracts
GUEST SPEAKER
Changing peoples’ attitudes to became donors: difficulties and challenges
F. Oppenheimer1
1Clinical Institute of Nephrology and Urology (ICNU), Hospital Clínic de Barcelona, Barcelona, Spain
Living donor kidney transplantation (LKT) is an excellent alternative to increase the transplantation rate and reduce the list of patients waiting for a deceased donor. Over the last decades, the number of living donations has markedly increased, even in countries with a high rate of deceased donors, like Spain. However, LKT activity rates vary along the European countries and these differences are not well explained by differences in the health care system, cultural or religious attitudes or richness ranking.
Important points in the suitability and promotion of living donation are, in addition to national legislation and health-care organization and resources, the Nephrologists attitudes onwards it. Many patients with end-stage kidney disease and the general public have misconceptions about living donation or feel uncomfortable with living donors undertaking harm. Whereas Nephrologist and nurses in care of these patients have the maximum capacity to appropriately inform the patients, Internet is today the principal source of information. However, identifying potential kidney donors using social networking is becoming popular, but concerns about some ethical issues and the risk of coercion or commercialism are present.
Proactive strategies are necessary to expand all modalities of LKT including unrelated donors, ABO- and/or HLA-incompatible donors and altruistic or paired-exchange donation.
A crucial period in defining the potential LKT alternatives is during the pre-dialysis stage. Systematic information about LKT as part of the ESRD treatment options is mandatory.
BIOGRAPHY OF THE GUEST SPEAKER
O 28
Live kidney donation Aotearoa - a New Zealand solution
D.Beechey1
1Renal Service, Counties Manukau Health, Auckland, New Zealand
Background
The Live Kidney Donation Aotearoa Project is a 3 year iniative to increase the number of people donating kidneys to patients with end stage kidney disease either before commencing dialysis or receiving dialysis treatment at Counties Manukau Health (CMH), South Auckland, New Zealand . The focus is on indigenous Maaori and migrant Pasifika people both donating and receiving kidneys as there is a demonstrated disparity compared with the rest of the CMH dialysis population.
Year 1 (2013) of the project predominantly involved the development of all the resources with year 2 and 3 of the project being the implementation period.
Objectives
The project aims to increase live kidney donation offers and completed donation in the Counties Manukau area over 3 years using a multi-faceted health-service delivery improvement project to educate, encourage and facilitate live donation.
Methods
Established to enable a whole renal service and community approach to improve live donation offers and transplantation. These include resource development, peer support, home based education, policy change,community engagement and primary health care education.
Results
Live kidney donor offers have increased from average of 10 per year to 59 May 2013-May 2014 and 84 May 2014–May 2015
Live kidney donation has increased from average of 2 per year to 15 in 2014 and 17 in 2015
Patient referral rates for renal transplant assessment and LKD have increased from 39.4%to 59%
Conclusion/Application to practice
This project has demonstrated that a wide ranging approach to improving live kidney donation has resulted in improved patient outcomes for priority populations in CMH.
O 29
Impact of an organ donation initiative – team-working across the NHS, charities & communities
N. Jain1, O. Lewis2, K. Modi2, P. Niven3, T. Norman4, M.L. Nation1
1Development , Kidney Research UK, Peterborough, United Kingdom; 2NBTA, NBTA, London, United Kingdom; 3Organ Donation and Transplantation , Scottish Government , Edinburgh, United Kingdom; 4Transplant Policy , Department of Health , London, United Kingdom
Background
Kidney failure is up to 5x more common in Black, Asian and minority ethnic (BAME) communities in the UK. These patients have to wait up to a third longer for an organ transplant due to a shortage of BAME donors and account for almost twice as many patients on the kidney transplant waiting list.
Objectives
We are developing a “bottom up” approach to engaging with people in BAME communities to raise awareness of these issues and to encourage donation.
Methods
We used our award winning Peer Educator (PE) initiative: motivated people from the targeted communities, trained to engage with their peers with whom they have a natural cultural/linguistic empathy. Training courses are at accredited standards.
Results
An independent evaluation team provided the evidence base for our initiative which was published in Clinical Kidney Journal 2015. We have been proactively approached by English & Scottish Governments and commissioned to deliver donation projects. Further funding has followed. The Birmingham PE team has national and local government support. Across all awareness programmes, we have trained >130 PEs, reached >27,000 ‘at risk’ people, and registered >2,700 potential donors I felt a great sense of pride and accomplishment… Education is the key to success in such a process…” (Senior P E).
Conclusion/Application to practice
The model is a proven, culturally sensitive, effective and a highly adaptable approach to addressing health and organ donation issues. Work is ongoing and the session will detail current projects and wider application. This is especially pertinent as the proportion of BAME communities will increase in Europe.
O 30
Psychosocial experiences of kidney transplant patients before and after transplantation
E.S. Gunduz1, N. Akyolcu2
1Vocational of Health Services, Akdeniz University, Antalya, Turkey; 2Istanbul University, Istanbul, Turkey
Background
Physical for the patient and family, emotional and economic aspects of transplantation is an important life experience. Good organizational success in transplantation , surgery preparation, and post-operative care, as well as biopsychosocial care and rehabilitation, is extremely important. Care interventions should be based on the individuality of the patient and should be undertaken in line with requirements.
Objectives
Of patients who underwent renal transplantation, and to identify psychosocial problems in this research conducted in order to gather comprehensive information on their experience in the transport process, phenomenological type of qualitative research design was used.
Methods
The research population , the province of Antalya Akdeniz University Hospital Organ Transplant Center of the planned 15 patients with organ transplants formed .A sample used in qualitative research " Purposive Sampling " and " Quota sampling. In -depth individual interview data were collected by semi-structured form.A week in the hospital before surgery and after surgery, including two interviews were done after 6 months. Content analysis Data were analyzed with SPSS17 and N- Vivo7 program.
Results
The average age of participants 38, 53.3 % male, 33.3 % of primary school graduates , 13.3 % unable to work ,
73.3 % were married, ort.7,3 years renal failure patients , 60% 0 of haemodialysis , transplant waiting period 4.5 years
66.7% had a live donor transplants, 20% of mothers transmitter , the transmitter is equal to 20.0 %.
Pre-transplant themes ; Experiences and Perceptions of Coping (illness perception, anxiety,
interpersonal relationships , individual coping ),
the Emotions Regarding Transmission (meaning for individuals of organ transplants )
Posttransplant themes ; Early Experiences ( be happy, live strain );
Long-Term Experience ( mood changes , changes in self-perception ,
the meaning for the individual organ transplantation , interpersonal relationships ,
productivity, individual coping studies ,
perception of the body, feelings towards organ donor )
as thus categorized reached a large number of sub-themes .
Conclusion/Application to practice
This research will contribute to the literature and a limited number are expected to lead to new research.
O 31
Why don’t we donate? – Nurses’ and midwives’ attitudes towards transplantation
A. Kliś1, A. Trzcińska2
1Hemodilysis Unit, Szpital Wojewódzki, Bielsko-Biała, Poland; 2Medical University of Silesia, Katowice, Poland
Background
Organ transplantation is a treatment method, which annually saves the lives of about 1500 people in Poland. However, the needs are much greater. Although there are many social campaigns promoting organ transplantation, the total number of transplants in the year 2015 was lower than in the previous year. It’s still a controversial method and many people cannot decide whether to donate organs after death in spite of the topic being widely discussed in media - see the spectacular successes in this area, like face and hands transplantation or cross transplantation of kidney from living donors.
Objectives
Recognize the attitudes and opinions of nurses and midwives on organ donation and transplantation.
Methods
The research in the form of the author’s questionnaire was conducted in 2015 among 187 respondents: nurses (N = 172), midwives (N = 15) from the South of Poland.
Results
Nurses and midwives have a positive attitude to transplantation:
96% of respondents accepted transplantation as a form of treatment (from both deceased or living donor) and 90% declared the willingness to be a donor. The consent to donate organs of a deceased close relative declared over 63%. Almost 63% of respondents talked to their loved ones on donation organs. Most nurses believed that death occurs when the brain doesn’t work even though the heart is still beating (brain death), but midwives often chose the answer where death means ceased brain and heartbeat functions.
Conclusion/Application to practice
Despite the fact that almost all respondents accept transplantation, there are still some areas that need further education, like brain death determination, legal aspects or even the possibility to object to transplantation.