Quality of life after renal transplantation

Abstract

End stage renal disease (ESRD) inevitably reduces the life-span of its victims. The treatment of choice for many patients is transplantation but this does not effect a cure. Its aim is to improve renal function and thus to enhance the patient's ability to enjoy as full a life as possible. However, surprisingly little research has been concerned with quality of life after transplantation. A small-scale, exploratory study employing a qualitative design was undertaken to compare stress and quality of life between five patients with ESRD awaiting transplantation and five patients who had received a graft within the previous 6 months. The desire to undergo transplantation was fuelled by patients' perceived need to 'get off dialysis' and to 'lead a normal life'. All patients had received abundant technical information about renal transplantation and pre-operative preparation but information concerning the negative effects of transplantation, including the side-effects of medication appeared lacking. It was not possible to determine whether this information had not been supplied or had been offered but forgotten or denied. For pre-transplantation patients the main sources of stress were the need to undergo dialysis, awaiting the summons to hospital and the social isolation imposed by having a chronic condition such as constant fatigue. Post-transplantation patients were remarkably free of anxiety considering the impositions placed upon them by frequent clinic attendance to monitor their condition. Quality of life improved dramatically after transplantation despite the persistence of renal symptoms and patients felt privileged to have been offered this treatment option.

Qualidade de vida e estratégias de enfrentamento em pacientes submetidos a transplante renal

“…Alguns autores relatam resultados positivos, ou seja, melhora na qualidade de vida após o transplante, enquanto outros rejeitam esses achados (Fisher, Gould, Wainwright, & Fallon, 1998). A ausência de melhora significativa na qualidade de vida de pacientes transplantados tem sido discutida por diversos autores e parece estar relacionada à preocupação com a saúde física, especialmente rejeição do enxerto, mudança na imagem corporal decorrente dos efeitos da medicação imunossupressora e a ansiedade sobre perspectivas futuras, como vida profissional (Fisher et al, 1998;Fujisawa et al, 2000;Ostrowiski, Wesolowski, Makar, & Bohatyrewicz, 2000 (Fisher et al, 1998). Embora não tenha sido encontrada diferença estatisticamente significante entre os escores de qualidade de vida pré e pós-transplante, a análise da média dos escores aponta diferença positiva na avaliação da qualidade de vida após o transplante.…”

Utility of Prostate Cancer Screening in Kidney Transplant Candidates

“…9,17,22 The ability to lead a normal life off of dialysis is a privilege that many transplant candidates value most highly, 23,24 and delaying transplant by .2 years is a substantial opportunity cost, especially because two thirds of patients die within 5 years of initiation of dialysis. 19 Because only one of 430 reported causes of death in our cohort was directly attributable to PC, the monetary and psychologic costs associated with PC screening warrant a higher level of scrutiny.…”

A longitudinal interpretative phenomenological analysis of the process of kidney recipients’ resolution of complex ambiguities within relationships with their living donors

“…She made a decision not to disclose this to participants in case this influenced responses. There is evidence to suggest that transplant recipients can be keen to prove their 'deservedness' and gratitude, perhaps as a way of re-paying the second chance of life they have been given (Fisher et al, 1998). Consequently, transplant recipients may feel under pressure to present themselves a certain way when speaking to donors, so it was felt that this would not be helpful information.…”