Browsing by Subject "kidney transplant"

Now showing 1 - 6 of 6
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    Is the kidney donor profile index (KDPI) universal or UNOS-specific?
    (Wiley, 2017) Ekser, Burcin; Powelson, John A.; Fridell, Jonathan A.; Goggins, William C.; Taber, Tim E.; Surgery, School of Medicine
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    The multidimensional kidney transplant self-management scale : development and psychometric testing
    (2018-04-03) Chung, Shu-Yu; Hacker, Eileen; Jones, Josette; Ellis, Rebecca Bartlett; Rawl, Susan; Bakas, Tamilyn
    Poor long-term kidney transplant outcomes are a significant problem in the U.S. Interventions must focus on preserving allograft function by managing modifiable risk factors. An instrument capable of identifying problems with post-kidney transplant self-management behaviors may enable the design and testing of self-management interventions. This study’s purpose was to test the psychometric properties of the new Kidney Transplant Self-Management Scale (KT–SM). The Zimmerman framework adapted for kidney transplant self-management guided the cross-sectional study. A total of 153 kidney recipients recruited from Facebook® completed the Self-Efficacy for Managing Chronic Disease (SEMCD), Patient Activation Measure (PAM), Kidney Transplant Questionnaire (KTQ), and KT–SM Scale instruments via a REDCap® survey. Most participants were female (65%), White (81.7%), and middle-aged (M = 46.7; SD = 12.4 years) with a history of dialysis (73%) and received a kidney transplant an average of 6.58 years previous (SD = 6.7). Exploratory factor analysis results supported the 16-item KT–SM Scale as a multidimensional scale with five domains with loadings ranging between .39 and .89: medication adherence, protecting kidney, cardiovascular risk reduction, ownership, and skin cancer prevention. Internal consistency reliability for the total scale (Cronbach’s α = .84) and five domains ranged from .71 to .83. The total and domains were positively correlated, ranging from r = .51 to .76, p = .01. Criterion-related validity was evidenced by significant correlations of KT–SM and domains with SEMCD (r =.22 to .53, p = .01), PAM (r = .31 to .52, p = .01), and the overall KTQ (r = .20 to .32, p = .01) except for one KT–SM domain: protecting kidney. Construct validity was evaluated using multivariate regression analysis. The linear combination of age, patient activation, and self-efficacy explained 45% of the variance in KT–SM behaviors; 47% of the variance in KTQ (measuring quality of life) was predicted by age, comorbidity, and self-efficacy. These findings provide beginning evidence of reliability and validity for the newly developed KT–SM scale. Instruments like this may provide a means to capture the self-management behaviors of the kidney transplant population, which is critical for future work on interventions.
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    Neutropenic fever in COVID-19 in kidney transplant patient
    (Wiley, 2021-01) Al-Makki, Akram; Taber, Tim; Medicine, School of Medicine
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    Patient and Graft Survival Outcomes During 2 Eras of Immunosuppression Protocols in Kidney Transplantation: Indiana University Retrospective Cohort Experience
    (Elsevier, 2021-12) Adebiyi, Oluwafisayo; Umukoro, Peter; Sharfuddin, Asif; Taber, Tim; Chen, Jeanne; Lane, Kathleen A.; Li, Xiaochun; Goggins, Williams; Yaqub, Muhammad S.; Biostatistics, School of Public Health
    Background Since 1964 when Indiana University performed its first kidney transplant, immunosuppression protocol was steroid-based until 2004 when steroid-free immunosuppression protocol was adopted. We describe clinical outcomes on our patients administered early steroid withdrawal (ESW) protocol (5 days) compared with our historical cohort (HC), who were on chronic steroid-based immunosuppression. Methods We performed a retrospective study evaluating kidney transplant recipients between 1993 and 2003 (HC, n = 1689) and between 2005 and 2016 (ESW cohort, n = 2097) at the Indiana University program, with a median follow-up of 10.5 years and 6.1 years, respectively. Primary outcomes were patient and death-censored graft survival at 1, 3, and 5 years in both study cohorts. Secondary outcomes were 1-year rates of biopsy-proven acute rejection; graft function at 1, 3, and 5 years; and risk of post-transplant infection (BK virus and cytomegalovirus) in the ESW cohort. Cox proportional model and Kaplan-Meier estimates were used to estimate survival probabilities. Fisher exact tests were used to compare episodes of acute rejection in the ESW cohort. Results No difference was observed in patient survival between the ESW and HC cohorts (P = .13). Compared with the ESW cohort, death-censored graft survival was significantly worse in the HC (5 year: 86.4% vs 90.6%, log-rank P < .001). One-year acute rejection reported in the ESW cohort alone was 15.7% and significantly worse in Black patients and younger patients (P < .05). Conclusions In this sizeable single-center cohort study with significant ethnic diversity, ESW is a viable alternative to steroid-based immunosuppression protocol in kidney transplant recipients.
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    Renal transplant complication: Ureteral obstruction
    (Elsevier, 2019-04) Roumpf, Steve; Welch, Julie L.; Zahn, Greg; Emergency Medicine, School of Medicine
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    SAT-315 Kidney Transplant Recipient Outcomes Using Older Living Donors With Hypertension
    (Elsevier, 2020-03) Sharfuddin, A.; Adebiyi, O.; Taber, T.; Mishler, D.; Yaqub, M. S.; Medicine, School of Medicine