Health and well-being of kidney transplant recipients in Iceland.

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnAð kanna líðan, heilsu og lífsgæði nýraígræðslu­ þega. Stuðningur og upplýsingagjöf til nýraþega voru könnuð sérstaklega og hvort munur væri á líðan nýraþega sem fengu nýra frá lifandi eða látnum gjafa. Þátttakendur og aðferð: Rannsóknin var megindleg og var spurningalisti sendur til allra nýraþega sem fengið hafa grætt í sig nýra frá lifandi eða látnum gjafa á Íslandi, voru eldri en 18 ára á tíma rannsóknar og gátu tjáð sig á íslenskri tungu (N=96). Annars vegar var í spurningalistanum að finna spurningar um bakgrunn, sjúkdómsferlið og líðan nýraþegans og hins vegar lífsgæðaspurningalistann SF 36v² ™. Alls svöruðu 73 einstaklingar spurningalistanum (76%). Þátttakendur voru á aldrinum 23 til 78 ára og 70% höfðu þegið nýra frá lifandi gjafa. Nýraþegar, sem fengu nýra frá látnum gjafa, höfðu verið lengur í skilun fyrir ígræðslu (p<0,001). Andleg heilsa nýraþega (samkvæmt SF 36v²) var sambærileg meðaltali samanburðarþýðis (47,28). Líkamleg líðan mældist undir meðaltali samanburðarþýðis (43,56). Ekki var marktækur munur á líðan, heilsu eða lífsgæðum nýraþega eftir því hvort þeir höfðu fengið nýra frá látnum eða lifandi gjafa. Nýraþegar, sem fengu nýra frá lifandi gjafa, höfðu fengið meiri stuðning frá heilbrigðisstarfsfólki. Átján prósent nýraþega, sem fengu nýra frá lifandi gjafa, og 46% nýraþega, sem fengu nýra frá látnum gjafa, töldu að sig hefði vantað fræðsluefni fyrir ígræðslu frá hjúkrunarfræðing. Álykta má að verri líkamleg líðan skýrist meðal annars af því að skilunarmeðferð, sem flestir nýraþegar þurfa fyrir aðgerð, er erfið og getur skert athafnafrelsi, og ónæmisbælandi lyfjameðferð eftir aðgerð getur haft áhrif á heilsu og líðan nýraþeganna. Auka þarf fræðslu og stuðning til nýraþega og þá sérlega þeirra sem fá nýra frá látnum gjafa.To investigate well being, health and quality of life of kidney transplant recipients (KTRs). Furthermore, we investigated the need for support and education for the KTR. Participants and methods: A questionnaire was sent to all Icelandic KTRs above 18 years of age and able to communicate in Icelandic (N=96). The questionnaire included questions about social background and also support and education that the KTRs received before transplantation. A separate questionnaire measured quality of life (SF 36v² ™). A total of 73 individuals responded to the questionnaire (76%). Participants were 23 78 years old and 70% received a kidney from a living donor (LDR). Eighty six percent of LDR was offered a kidney without having to ask for it. Recipients of deceased donor (DDR) kidneys were longer on dialysis before transplantation (p <0.001). Results showed that the mental health was comparable to the average US population (US: 47 52, our study: 47.28) but physical health was below the average (43.56). A comparison of LDR and DDR showed no difference in well being, health and quality of life. Eighteen percent of LDR and 46% of DDR stated that they lacked information or education from nurses before the transplantation. Physical health was estimated to be worse than mental health which may be explained by illness related to the kidney failure, dialysis treatment before transplantation,complications related to immunosuppressive drugs and co-morbidities after transplantation. Our findings further indicate that information and education from health care professionals, in particular to patients on a waiting list for a deceased donor kidney, needs to be improved.Félag íslenkra hjúkrunarfræðinga, Vísindasjóður Landspítalan

Scandiatransplant Exchange Program (STEP) : Development and Results From an International Kidney Exchange Program

Copyright © 2023 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.BACKGROUND: Kidney transplant candidates may be incompatible with their intended living donors because of the presence of antibodies against HLA and/or ABO. To increase the possibility of finding an acceptable kidney donor for these patients, the Scandiatransplant Exchange Program (STEP) program within Scandiatransplant was launched in 2019. METHODS: This is a retrospective review of our experiences from the first 4 y of the STEP program, including details about the match runs, performed transplantations, and recipient outcomes within the program. RESULTS: During 2019-2022, 11 match runs and 4 reruns were performed. In total, 114 pairs and 6 anonymous donors participated in these match runs. Fifty-one pairs (45%) participated in 1 match run, 31 pairs (27%) participated in 2 match runs, and 32 pairs (29%) participated in ≥3 match runs. Seventy-two individuals (63%) participated because of HLA incompatibility, 19 (17%) because of ABO incompatibility, and 7 (6%) because of both HLA and ABO incompatibility.Forty percent of the patients enrolled in the program underwent transplantation. In total, 49 transplantations have so far been performed within the program, and 46 (94%) of the recipients had a functioning kidney graft at follow-up in February 2023. CONCLUSIONS: The STEP program offers sensitized patients an enlarged pool of living donors and a chance of a compatible international living donor, resulting in an increased number of total transplantations. Currently, STEP is one of the largest transnational kidney exchange programs and has improved the situation for patients waiting for kidney transplantation in Scandiatransplant.Peer reviewe

Recurrence of glomerulonephritis after renal transplantation: a single-centre study

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Organ transplantation - a complex process

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Acute flank pain syndrome: a common presentation of acute renal failure in young men in Iceland

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Objectives: The purpose of the study was to calculate the incidence of the acute flank pain syndrome in Iceland and to describe the case series. Material and methods: The hospital records of those who fulfilled the following criteria were studied: age 18-41 years, acute renal failure, and a visit to Landspitali University Hospital in 1998-2007. The acute flank pain syndrome was defined as severe flank pain in combination with acute renal failure, unexplained except for the possible consumption of NSAIDs, ethanol or both. Information was collected about the sales of NSAIDs. Results: One hundred and six patients had acute renal failure. Of those, 21 had the acute flank pain syndrome (20%). The annual incidence of the acute flank pain syndrome increased threefold during the study period. The average incidence was 3.2/100.000/year (relative to the population of the Reykjavik area) and 2.0/100.000/year (relative to the population of Iceland). 18 patients were male and the median age was 26 (19-35) years. The symptoms regressed spontaneously during a few days or weeks. There was history of NSAID intake in 15, ethanol consumption in 15, either in 20, and both in nine patients. The sales figures of NSAIDs were high and they increased during the study period, especially those of the over-the-counter sales of ibuprofen. Conclusions: The incidence of the acute flank pain syndrome was high. The paper describes the largest case series that has been published since the withdrawal of suprofen in 1987. Young people should be warned about consuming NSAIDs during or directly after binge drinking.Tilgangur: Brátt síðuheilkenni var algeng aukaverkun bólgueyðandi verkjalyfsins súprófens sem var afskráð 1987. Síðan hefur fáum tilfellum verið lýst hjá ungu fólki í tengslum við neyslu bólgueyðandi verkjalyfja, áfengis eða hvors tveggja. Tilgangur rannsóknarinnar var að kanna nýgengi bráðs síðuheilkennis hér á landi og lýsa tilfellaröð. Efniviður: Sjúkraskrár þeirra sem uppfylltu eftirtalin skilyrði voru lesnar: aldur 18-41 árs, bráð nýrnabilun og koma á Landspítala 1998-2007. Brátt síðuheilkenni var skilgreint sem svæsinn verkur í síðu eða kviði ásamt bráðri nýrnabilun, án annarrar skýringar en hugsanlegrar neyslu bólgueyðandi verkjalyfja, áfengis eða hvors tveggja. Upplýsinga var leitað um sölutölur bólgueyðandi verkjalyfja. Niðurstöður: Hundrað og sex sjúklingar fengu greininguna bráð nýrnabilun, þar af 21 með brátt síðuheilkenni (20%). Árlegt nýgengi bráðs síðuheilkennis þrefaldaðist á tímabilinu. Átján sjúklingar voru karlkyns og miðgildi aldurs var 26 (19-35) ár. Einkenni gengu yfir á nokkrum dögum eða vikum. Það var saga um nýlega neyslu bólgueyðandi verkjalyfja hjá 15, áfengis hjá 15, annars hvors hjá 20 og hvors tveggja hjá níu sjúklingum. Sala á bólgueyðandi verkjalyfjum var mikil og vaxandi, einkum á íbúprófeni í lausasölu. Ályktanir: Nýgengi bráðs síðuheilkennis var hátt. Greinin lýsir stærstu tilfellaröð sem birst hefur síðan súprófen var tekið af markaði. Margföld aukning varð á nýgengi bráðs síðuheilkennis og lausasölu íbúprófens á tímabilinu. Það er ástæða til að vara ungt fólk við neyslu bólgueyðandi verkjalyfja samtímis eða í kjölfar áfengisneyslu

Acute flank pain syndrome: a common presentation of acute renal failure in young men in Iceland

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Objectives: The purpose of the study was to calculate the incidence of the acute flank pain syndrome in Iceland and to describe the case series. Material and methods: The hospital records of those who fulfilled the following criteria were studied: age 18-41 years, acute renal failure, and a visit to Landspitali University Hospital in 1998-2007. The acute flank pain syndrome was defined as severe flank pain in combination with acute renal failure, unexplained except for the possible consumption of NSAIDs, ethanol or both. Information was collected about the sales of NSAIDs. Results: One hundred and six patients had acute renal failure. Of those, 21 had the acute flank pain syndrome (20%). The annual incidence of the acute flank pain syndrome increased threefold during the study period. The average incidence was 3.2/100.000/year (relative to the population of the Reykjavik area) and 2.0/100.000/year (relative to the population of Iceland). 18 patients were male and the median age was 26 (19-35) years. The symptoms regressed spontaneously during a few days or weeks. There was history of NSAID intake in 15, ethanol consumption in 15, either in 20, and both in nine patients. The sales figures of NSAIDs were high and they increased during the study period, especially those of the over-the-counter sales of ibuprofen. Conclusions: The incidence of the acute flank pain syndrome was high. The paper describes the largest case series that has been published since the withdrawal of suprofen in 1987. Young people should be warned about consuming NSAIDs during or directly after binge drinking.Tilgangur: Brátt síðuheilkenni var algeng aukaverkun bólgueyðandi verkjalyfsins súprófens sem var afskráð 1987. Síðan hefur fáum tilfellum verið lýst hjá ungu fólki í tengslum við neyslu bólgueyðandi verkjalyfja, áfengis eða hvors tveggja. Tilgangur rannsóknarinnar var að kanna nýgengi bráðs síðuheilkennis hér á landi og lýsa tilfellaröð. Efniviður: Sjúkraskrár þeirra sem uppfylltu eftirtalin skilyrði voru lesnar: aldur 18-41 árs, bráð nýrnabilun og koma á Landspítala 1998-2007. Brátt síðuheilkenni var skilgreint sem svæsinn verkur í síðu eða kviði ásamt bráðri nýrnabilun, án annarrar skýringar en hugsanlegrar neyslu bólgueyðandi verkjalyfja, áfengis eða hvors tveggja. Upplýsinga var leitað um sölutölur bólgueyðandi verkjalyfja. Niðurstöður: Hundrað og sex sjúklingar fengu greininguna bráð nýrnabilun, þar af 21 með brátt síðuheilkenni (20%). Árlegt nýgengi bráðs síðuheilkennis þrefaldaðist á tímabilinu. Átján sjúklingar voru karlkyns og miðgildi aldurs var 26 (19-35) ár. Einkenni gengu yfir á nokkrum dögum eða vikum. Það var saga um nýlega neyslu bólgueyðandi verkjalyfja hjá 15, áfengis hjá 15, annars hvors hjá 20 og hvors tveggja hjá níu sjúklingum. Sala á bólgueyðandi verkjalyfjum var mikil og vaxandi, einkum á íbúprófeni í lausasölu. Ályktanir: Nýgengi bráðs síðuheilkennis var hátt. Greinin lýsir stærstu tilfellaröð sem birst hefur síðan súprófen var tekið af markaði. Margföld aukning varð á nýgengi bráðs síðuheilkennis og lausasölu íbúprófens á tímabilinu. Það er ástæða til að vara ungt fólk við neyslu bólgueyðandi verkjalyfja samtímis eða í kjölfar áfengisneyslu