- 著者
- 瀬戸 加奈子 松本 邦愛 高橋 絹代 藤田 民夫 高原 史郎 相川 厚 篠崎 尚史 長谷川 友紀
- 出版者
- 一般社団法人 日本移植学会
- 雑誌
- 移植 (ISSN:05787947)
- 巻号頁・発行日
- vol.52, no.4-5, pp.346-351, 2017-09-30 (Released:2017-11-24)
- 参考文献数
- 10
Although public opinion polls reported that over 40% of Japanese people want to donate their organs at death, the number of organs remains low (=< 1 donor/million population). This low donation rate is supposed to be due to the lack of an in-hospital system to confirm patient desires to donate organs to patients at hospitals. The purpose of this study is to develop and evaluate the educational program to improve the quality of terminal care at acute care hospitals in the form of a QM (quality management) seminar at emergency departments, focusing on management methods and quality management to facilitate and establish an in-hospital system. From 2013 to 2015, there were 94 participants. Pre- and post-program test showed that the improvement rate was 15.9% for transplantation medical care, 6.9% for skills, and 10.5% for the management method. By the educational method, the improvement rate was 10.1% for lecture and 10.2% for group-work exercise (+ lecture). Compared with doctors, nurses had a lower improvement rate in the domain of management methods. A questionnaire survey showed that the participants evaluated that management method was difficult and their understanding level was low, but they highly recommended participation. To improve the quality terminal care, the role of nurses is important because they are the major players in patient care, and revision to improve the educational program is necessary to provide outcomes similar to those doctors produce. Other supporting methods, such as the provision of educational tools and sharing success cases, should be considered to facilitate in-hospital system development.
1 0 0 0 OA 小児腎移植患者におけるtacrolimusの徐放性製剤への変更時の薬物動態の検討
- 著者
- 兵頭 洋二 宍戸 清一郎 河村 毅 櫻林 啓 新津 靖雄 二瓶 大 青木 裕次郎 村松 真樹 酒井 謙 相川 厚
- 出版者
- 一般社団法人 日本移植学会
- 雑誌
- 移植 (ISSN:05787947)
- 巻号頁・発行日
- vol.48, no.1, pp.042-047, 2013-03-10 (Released:2014-10-03)
- 参考文献数
- 10
【Objective】The purpose of this study was to evaluate pharmacokinetic (Pk) profile of newly developed modified release tacrolimus (MR-TAC) in pediatric kidney transplant recipients.【Methods】According to our current immunosuppressive protocol, tacrolimus (TAC) was initially given and converted to MR-TAC in 13 pediatric patients who received kidney transplantation from April 2010 to April 2011. The switch dose ratio was 1:1, and the 24hour full Pk study was assessed before and after the conversion from TAC to MR-TAC.【Results】The mean total daily dose at baseline upon enrollment was 5.4±3.3 mg. There was no significant correlation between the oral dose and the trough concentration (C0) of TAC/MR-TAC. The consecutive Pk studies revealed no significant difference in the mean time to maximum concentration (Tmax) / maximum concentration (Cmax) and the area under the time-concentration curve (AUC0-24) of both reagents; the mean C0 of MR-TAC was 18% lower than those of TAC. A better correlation between AUC0-24 and C0 was observed in MR-TAC compared to that in TAC (r2=0.912, for MR-TAC; r2>0.555, for TAC). 【Conclusion】In the conversion from TAC to MR-TAC, AUC0-24 was equivalent despite the 18% reduction of C0, even in the pediatric kidney transplant recipients. The trough concentration might be an excellent predictor in the therapeutic drug monitoring of MR-TAC because of its better correlation of C0 and AUC0-24.