Karepalli, Vijay; Brown M; Sajiv C; Fernandes, David; Thomas S; George, Pratish; Nayar S; Pawar B

Author(s)

Karepalli, Vijay

Brown M

Sajiv C

Fernandes, David

Thomas S

George, Pratish

Nayar S

Pawar B

Publication Date

2021-01-18

Abstract

BACKGROUND: The majority of patients living in remote communities of Central Australia must relocate to Alice Springs for their dialysis treatments. There is limited information available, about the challenges and barriers that Aboriginal patients encounter in the process of returning back to their communities after renal transplantation. AIM: To determine the length of stay of patients in Alice Springs and challenges faced subsequent to renal transplantation, before they could safely return to their remote communities. METHODS: All transplant recipients from 2012 who are aged 18 were analysed retrospectively. RESULTS: Thirty-six patients received renal transplantation from Central Australia. Of them, 25 were from very remote communities of whom 24 were aboriginal. Average length of stay in Alice Springs post transplantation prior to returning to community was 17.2 weeks (121 days). The most common challenge faced prior to returning to community was the need for monitoring and titration of immunosuppressive medication (100%) followed by infections (90%) and admissions to hospital (85%). The other common barrier was optimizing glycaemic control (80%). Less common barriers included proficiency with self-monitoring of blood sugar levels (BSL) (50%), social factors (40%), blood pressure control (25%), safe housing (20%), leukopenia (25%) and rejection episodes (15%). CONCLUSION: Multiple challenges are faced during post-transplantation period in Alice Springs which prolong the time before recipients from remote communities can return home. Some barriers such as titration of immunosuppression are inherent in the transplant journey. However, some factors might be modifiable prior to transplantation. This article is protected by copyright. All rights reserved.

Affiliation

Alice Springs Hospital, Alice Springs, NT.

Citation

Intern Med J. 2021 Jan 18. doi: 10.1111/imj.15196.

OrcId

0000-0002-2355-1951

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/33462991/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/11633

Title

Barriers and challenges of returning patients back to community after renal transplantation in Central Australia.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Karepalli, Vijay Brown M Sajiv C Fernandes, David Thomas S George, Pratish Nayar S Pawar B
Publication Date	2021-01-18
Abstract	BACKGROUND: The majority of patients living in remote communities of Central Australia must relocate to Alice Springs for their dialysis treatments. There is limited information available, about the challenges and barriers that Aboriginal patients encounter in the process of returning back to their communities after renal transplantation. AIM: To determine the length of stay of patients in Alice Springs and challenges faced subsequent to renal transplantation, before they could safely return to their remote communities. METHODS: All transplant recipients from 2012 who are aged 18 were analysed retrospectively. RESULTS: Thirty-six patients received renal transplantation from Central Australia. Of them, 25 were from very remote communities of whom 24 were aboriginal. Average length of stay in Alice Springs post transplantation prior to returning to community was 17.2 weeks (121 days). The most common challenge faced prior to returning to community was the need for monitoring and titration of immunosuppressive medication (100%) followed by infections (90%) and admissions to hospital (85%). The other common barrier was optimizing glycaemic control (80%). Less common barriers included proficiency with self-monitoring of blood sugar levels (BSL) (50%), social factors (40%), blood pressure control (25%), safe housing (20%), leukopenia (25%) and rejection episodes (15%). CONCLUSION: Multiple challenges are faced during post-transplantation period in Alice Springs which prolong the time before recipients from remote communities can return home. Some barriers such as titration of immunosuppression are inherent in the transplant journey. However, some factors might be modifiable prior to transplantation. This article is protected by copyright. All rights reserved.
Affiliation	Alice Springs Hospital, Alice Springs, NT.
Citation	Intern Med J. 2021 Jan 18. doi: 10.1111/imj.15196.
OrcId	0000-0002-2355-1951
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/33462991/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/11633
Title	Barriers and challenges of returning patients back to community after renal transplantation in Central Australia.
Type of document	Journal Article
Entity Type	Publication

Barriers and challenges of returning patients back to community after renal transplantation in Central Australia.

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