Despite the success of transplantation, many transplant candidates and transplant recipients die each year. Some die awaiting transplants and some die months or years after receiving an organ. Quality end-of-life care can play a valuable role in easing the impact of death and dying in transplantation, as it focuses on enhancing patients' quality of life near death. Quality end-of-life care recognizes the values and preferences of patients and their families, and involves a process of shared decision making about patients' healthcare treatment in collaboration with healthcare practitioners. Advance care planning involves discussions with patients about their wishes and values about care, in the event that the patient becomes incapable of making such decisions. This article focuses on the application to transplantation of quality end-of-life care and advance care planning and identifies the effects that death and dying of transplant patients have on others. The information herein encourages healthcare practitioners to view and deliver quality end-of-life care as part of transplant patients' overall treatment management.
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http://dx.doi.org/10.1177/152692480701700109 | DOI Listing |
JAMA Surg
January 2025
Population Health Research Institute, Hamilton, Ontario, Canada.
Importance: Perioperative bleeding is common in general surgery. The POISE-3 (Perioperative Ischemic Evaluation-3) trial demonstrated efficacy of prophylactic tranexamic acid (TXA) compared with placebo in preventing major bleeding without increasing vascular outcomes in noncardiac surgery.
Objective: To determine the safety and efficacy of prophylactic TXA, specifically in general surgery.
JAMA
January 2025
Department of Emergency Medicine, Henry Ford Health, Detroit, Michigan.
Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.
Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.
Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.
J Bone Joint Surg Am
January 2025
Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island.
➢ Advanced care planning most commonly refers to the act of planning and preparing for decisions with regard to end-of-life care and/or serious illness based on a patient's personal values, life goals, and preferences.➢ Over time, advanced care planning and its formalization through advanced directives have demonstrated substantial benefits to patients, their families and caregivers, and the larger health-care system.➢ Despite these benefits, advanced care planning and advanced directives remain underutilized.
View Article and Find Full Text PDFAging (Albany NY)
January 2025
Department of Medicine, Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan.
Introduction: Bone turnover markers reflected the bone remodeling process and bone health in clinical studies. Studies on variation of bone remodeling markers in different stage CKD were scant, and this study investigated the role of bedside intradialytic cycling in altering concentrations of bone-remodeling markers in patients with end-stage renal disease (ESRD).
Materials And Methods: Participants were segmented into four groups: a group with eGFR >60 ml/min/1.
Med J Malaysia
January 2025
Universiti Sultan Zainal Abidin, Faculty of Medicine, Kampus Perubatan, Jalan Sultan Mahmud, Kuala Terengganu, Malaysia.
Introduction: Pancreatic cancer incidence in Malaysia is steadily on the rise, now ranking as the 14th most common malignancy in the country. Despite this upward trend, research on prognostic factors affecting pancreatic cancer survival remains limited, highlighting the need for ongoing investigation to improve patient survival outcomes.
Materials And Methods: This study was conducted retrospectively by reviewing records of pancreatic cancer patients hospitalized between January 2011 and December 2018 across multiple health centres in Malaysia.
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