J Korean Soc Transplant.  2010 Dec;24(4):272-283.

Current Management for Patients on the Waiting List of Deceased Donor Kidney Transplantation in Korea

• Bang K
• Kim MG
• Byeon N
• Kim Y
• Jeong JC
• Ro H
• Oh YK
• Min SI
• Ha J
• Cho W
• Yang J
• Ahn C

Abstract

BACKGROUND
Health maintenance and monitoring of transplant candidates, the great majority of whom are undergoing chronic dialysis, can be a determinant of post-transplant prognosis. New issues such as malignancy, inflammation, cardiovascular disease, and psychosocial problems might arise among potential recipients, which may lead to cancellation of the transplantation.
METHODS
A questionnaire, including questions regarding follow-up monitoring, was sent to 66 transplant centers, and responses to the survey were obtained from 35 centers (53%). A similar questionnaire was sent to 217 wait-listed patients, and 164 (76%) responded.
RESULTS
Regular contact between the transplant center and patients was maintained by only 37% of the centers. No consistent pattern of contact was observed for 11%. Sixty percent of the centers monitored patients by telephone. Three-fourths of the transplant centers monitored their patients annually or every 6 months. A cancer screening program was run by only 17% of the centers, and 29% did not routinely request cardiac screening. Most centers (83%) informed their patients of the features of marginal kidneys. However, many patients (69%) reported not hearing about marginal kidneys, and 43% indicated that a cadaver transplant was cancelled because of a cadaver donor problem.
CONCLUSIONS
Our survey indicates that the necessity for routine follow-up monitoring is broadly recognized by 86% of transplant centers and 78% of wait-listed patients However, no formal monitoring guidelines currently exist for wait-listed patients in Korea. Therefore, guidelines are absolutely necessary for improving the quality of post-transplant life.

Keyword

Cadaver donor; Kidney transplantation; Waiting lists; Survey

MeSH Terms

Cadaver
Cardiovascular Diseases
Dialysis
Early Detection of Cancer
Follow-Up Studies
Hearing
Humans
Inflammation
Kidney
Kidney Transplantation
Korea
Mass Screening
Prognosis
Surveys and Questionnaires
Telephone
Tissue Donors
Transplants
Waiting Lists

Figure

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  Fig. 1. Contact pattern and method of transplantation centers to patients on the waiting list. (A) % regular contact. (B) Method of contact. (C) Frequency of contact reported by transplantation centers. (D) Frequency of contact reported by patients.

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  Fig. 2. Standard cancer prevention screening recommendations.

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  Fig. 3. Screening for cardiovascular disease. (A) The subject of screening. (B) Screening methods. Abbreviations: CVA, cerebral vascular accident; DM, diabetes mellitus; MIBI, myocardial spect.

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