Impact of simultaneous pancreas-kidney transplantation: patients' perspectives

Abstract

P Isla Pera,1 J Moncho Vasallo,2 O Guasch Andreu,3 MJ Ricart Brulles,4 A Torras Rabasa4,51Public Health Department, Nursing School, Universitat de Barcelona, Barcelona, 2Community Nursing, Preventive Medicine and Public Health and History of Science, Universidad Alicante, 3Facultat Sociologia, Universitat de Barcelona, 4Institut Clínic de Nefrología i Urología, Hospital Clínic de Barcelona, 5Facultat de Medicina, Universitat de Barcelona, Barcelona, SpainBackground: Few qualitative studies of simultaneous pancreas-kidney transplantation (SPK Tx) have been published. The aims of this study were to explore from the perspective of patients, the experience of living with diabetes mellitus type 1 (T1DM), suffering from complications, and undergoing SPK Tx with good outcome; and to determine the impact of SPK Tx on patients and their social and cultural environment.Methods: We performed a focused ethnographic study. Twenty patients were interviewed. Data were analyzed using content analysis and constant comparison following the method proposed by Miles and Huberman.Results: A functioning SPK Tx allowed renal replacement therapy and insulin to be discontinued. To describe their new situation, patients used words and phrases such as "miracle", "being reborn" or "coming back to life". Although the complications of T1DM, its surgery and treatment, and associated psychological problems did not disappear after SPK Tx, these were minimized when compared with the pretransplantation situation.Conclusion: For patients, SPK Tx represents a recovery of their health and autonomy despite remaining problems associated with the complications of T1DM and SPK Tx. The understanding of patients' existential framework and their experience of disease are key factors for planning new intervention and improvement strategies.Keywords: qualitative research, ethnography, complications of diabetes mellitus type 1, simultaneous pancreas-kidney transplantation