腎臟移植的醫療照護現況

腎臟移植乃是以手術方式來治療末期腎臟疾病，由於醫療技術的進步、免疫抑制劑及移植免疫學日新月異的發展，使許多病患能於移植術後立即重獲腎臟功能並改善生活品質。而腎臟移植術後病患需透過與移植醫護團隊的密切配合，終生接受規則的追蹤與治療，才能確保良好之移植器官功能，進而提升其生活品質。站在醫護團隊照護層面的角度而言，如何教導病患自我健康管理與提昇自我照護能力，實為重要課題。故本文的主要目的乃為陳述目前腎臟移植的醫療照護現況，期望促進臨床醫護人員對此議題更深入之瞭解，進而教育腎臟移植病患自主管理其健康行為，以適時預防與減少併發症發生、達到提昇自我照護品質的目的。

關鍵字

腎臟移植；醫療照護；免疫抑制劑；排斥反應；移植術後併發症

並列摘要

Kidney transplantation is one strategy for treating end-stage renal disease. Recent advances in perioperative management and immunosuppressive agents as well as improved understanding of transplant immunology have improved the post-surgery quality of life of kidney recipients dramatically. However, lifelong monitoring of renal functions and potential complications is essential to ensure optimal medical outcomes. Furthermore, the self-care competency of transplant recipients is a significant factor affecting survival of the graft and the patient over the long term. All kidney transplant recipients should comply with the self-care instructions provided by transplantation medical personnel and work to improve their self-care abilities in order to prevent / detect post-transplant complications such as rejection, infection, and medical comorbidities as early as possible. The purpose of this study is to explore the current management and care issues faced by kidney transplant recipients.

並列關鍵字

kidney transplantation ； healthcare management ； immunosuppression ； rejection ； post-transplantcomplications

參考文獻

Chisholm, M. A. (2002). Issues of adherence to immunosuppressant therapy after solid-organ transplantation. Drugs, 62(4), 567-575. doi:10.2165/00003495-200262040-00002

Hansen, R., Seifeldin, R., & Noe, L. (2007). Medication adherence in chronic disease: Issues in posttransplant immunosuppression. Transplantation Proceedings, 39(5), 1287－1300. doi:10.1016/j.transproceed.2007.02.074

Howard, K., Salkeld, G., White S., Mcdonald, S., Chadban, S., Craig, J. C., & Cass, A. (2009). The cost-effectiveness of increasing kidney transplantation and home-based dialysis. Nephrology, 14(1), 123－132. doi:10.1111/j.1440-1797.2008.01073.x

Kasiske, B. L., Zeier, M. G., Chapman, J. R., Craig, J. C., Ekberg, H., Garvey, C. A., … Balk, E. M. (2010). KDIGO (Kidney Disease: Improving Global Outcomes) clinical practice guideline for the care of kidney transplant recipients: A summary. Kidney International, 77(4), 299－311. doi:10.1038/ki.2009.377

Kaufman, D. B. (2013). Assessment and management of the renal transplant patient. Retrieved from http://emedicine.medscape.com/article/429314-overview#aw2aab6b2

被引用紀錄

龔蘭芳、王淑麗、陳慈徽、陳麗系（2023）。腎臟移植病人術後自我照顧行為與其相關因素探討。高雄護理雜誌，40(2)，1-17。https://doi.org/10.6692/KJN.202308_40(2).0001

謝菁怡、許莉宛（2018）。照護一位胰腎移植病患術後之護理經驗。高雄護理雜誌，35(2)，104-115。https://doi.org/10.6692/KJN.201808_35(2).0010

陳筱玲、丁玉芝、熊道芬、顏好渝（2015）。一位新住民女性接受活體捐贈腎臟移植的護理經驗。彰化護理，22(1)，33-41。https://doi.org/10.6647/CN.22.01.16

吳（女秀）嫚、鄭采宸、吳律嫻（2020）。照顧一位末期腎病患者接受腎臟移植手術之護理經驗。彰化護理，27(3)，111-123。https://doi.org/10.6647/CN.202009_27(3).0014

彭宥慈、黃惠珠（2022）。照護一位手臂異體移植病人之護理經驗。新臺北護理期刊，24(2)，119-127。https://doi.org/10.6540/NTJN.202209_24(2).0011

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腎臟移植的醫療照護現況

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