Supportive care in transplantation: A patient-centered care model to better support kidney transplant candidates and recipients  

作　　者：Anita Slominska Katya Loban Elizabeth Anne Kinsella Julie Ho Shaifali Sandal 

机构地区：[1]MEDIC Program,Research Institute of the McGill University Health Centre,Montreal H4A3J1,QC,Canada [2]Institute of Health Sciences Education,Faculty of Medicine and Health Sciences,McGill University,Montreal H4A3J1,QC,Canada [3]Department of Medicine,University of Manitoba,Winnipeg R3A1R9,MB,Canada [4]Department of Medicine,McGill University Health Centre,Montreal H4A3J1,QC,Canada

出　　处：《World Journal of Transplantation》2024年第4期15-28,共14页世界移植杂志

摘　　要：Kidney transplantation(KT),although the best treatment option for eligible patients,entails maintaining and adhering to a life-long treatment regimen of medications,lifestyle changes,self-care,and appointments.Many patients experience uncertain outcome trajectories increasing their vulnerability and symptom burden and generating complex care needs.Even when transplants are successful,for some patients the adjustment to life post-transplant can be challenging and psychological difficulties,economic challenges and social isola-tion have been reported.About 50%of patients lose their transplant within 10 years and must return to dialysis or pursue another transplant or conservative care.This paper documents the complicated journey patients undertake before and after KT and outlines some initiatives aimed at improving patient-centered care in transplantation.A more cohesive approach to care that borrows its philosophical approach from the established field of supportive oncology may improve patient experiences and outcomes.We propose the"supportive care in transplantation"care model to operationalize a patient-centered approach in transplantation.This model can build on other ongoing initiatives of other scholars and researchers and can help advance patient-centered care through the entire care continuum of kidney transplant recipients and candidates.Multi-dimensionality,multi-disciplinarity and evidence-based approaches are proposed as other key tenets of this care model.We conclude by proposing the potential advantages of this approach to patients and healthcare systems.Core Tip:Kidney transplant recipients and candidates face several uncertainties in their care journey and have several expressed unmet healthcare needs.We recommend a structured and comprehensive approach to transplant care across the entire continuum of a transplant patient’s journey similar to what has been developed in the field of oncology.The supportive care in transplantation model can operationalize patient-centered care and build on the eff

关 键 词：Supportive care Kidney transplantation DEATH Graft failure Adverse outcomes Kidney transplant recipients 

分 类 号：R699.2[医药卫生—泌尿科学]