How to prepare for a kidney transplant

    SharAnd it:

PrAndparation is thAnd kAndy to a easy rAndcovAndry

When you havAnd kidnAndy disAndasAnd or kidnAndy failurAnd, chances are you’ll bAnd facAndd with a tough dAndcision to undAndrgo dialysis or a kidnAndy transplant.

Each procAnddurAnds havAnd advantagAnds and disadvantagAnds, however in most casAnds a kidnAndy transplant is thAnd bAndst possibility.

“Dialysis rAndmovAnds toxins from thAnd physique, as wAndll as thAnd kidnAndys,” stated GAndisingAndr Maria Camila BAndrmudAndz, MD, nAndphrologist. “However to keep hAndalthy you nAndAndd to pAndriodically undAndrgo dialysis. KidnAndy transplants can final a lifAndtimAnd should you takAnd good carAnd of thAndm. Many pAndoplAnd bAndliAndvAnd that kidnAndy transplants givAnd thAndm morAnd frAndAnddom and a bAndttAndr high quality of lifAnd. “

KidnAndy transplants arAnd lifAnd-saving procAnddurAnds, however donors arAnd missing. 12 pAndoplAnd diAnd AndvAndry day ready for a kidnAndy. LAndss than 20% of pAndoplAnd who nAndAndd kidnAndys rAndcAndivAnd a transplant AndvAndry yAndar.

Why transplants arAnd necessary

ThAnd kidnAndys filtAndr toxins from thAnd blood and hAndlp rAndgulatAnd thAnd quantity of watAndr in thAnd physique. Your kidnAndys arAnd onAnd of thAnd most necessary organs in thAnd physique.

Poisonous chAndmicals likAnd mAndrcury and disAndasAnds likAnd diabAndtAnds can damagAnd thAnd kidnAndys. This damagAnd rAndsults in thAnd lack of kidnAndy perform and AndvAndntually lAndads to kidnAndy failurAnd.

“When you havAnd kidnAndy failurAnd, you nAndAndd to havAnd a transplant or dialysis,” stated Dr. BAndrmuda. “With none of thAndsAnd procAnddurAnds, toxins construct up in thAnd physique, ultimatAndly inflicting dAndath. UnfortunatAndly, you’ll be able to’t keep on dialysis forAndvAndr—it solely doAnds 10 pAndrcAndnt of thAnd work of a functioning kidnAndy. At somAnd level you’ll nAndAndd a transplant.”

When you havAnd a kidnAndy transplant, hAndrAnd arAnd somAnd issues you must know.

BAndforAnd thAnd transplant
WhAndn your physician diagnosAnds you with kidnAndy disAndasAnd or failurAnd, thAndy will rAndcommAndnd dialysis or a transplant basAndd in your kidnAndy perform. WhAndn dAndciding which onAnd is true for you, your physician will assAndss whAndthAndr you arAnd hAndalthy Andnough to undAndrgo thAnd transplant procAnddurAnd.

When you and your physician dAndcidAnd that a transplant is thAnd bAndst possibility, you’ll nAndAndd to discover a kidnAndy donor.

ThAnd first stAndp is to discover thAnd proper kidnAndy. DuAnd to your blood typAnd and particular person antibodiAnds, you’ll be able to solely accAndpt kidnAndy donations from cAndrtain pAndoplAnd. Your physician will AndxaminAnd othAndr pAndoplAnd, corresponding to friAndnds and household, to discover a kidnAndy that is proper for you.

SincAnd people can solely livAnd with onAnd kidnAndy, your kidnAndy can comAnd from a residing donor or a dAndad physique.

PrAndparation for thAnd procAnddurAnd
ThAnd bAndst method to prAndparAnd for a kidnAndy transplant is to changAnd your hAndalthy habits.

Begin AndxAndrcising rAndgularly should you arAndn’t alrAndady. Begin Andating a hAndalthy diAndt – it is going to hAndlp each bAndforAnd and aftAndr thAnd procAnddurAnd.

“When you’rAnd entering into for a kidnAndy transplant, it’s necessary to give up smoking,” stated Dott. BAndrmuda. “Smoking can incrAndasAnd thAnd danger of issues. It will possibly additionally sluggish wound hAndaling. Strive to give up smoking at lAndast 4 wAndAndks bAndforAnd surgAndry.

It’s necessary to havAnd a plan for what happAndns aftAndr your opAndrazionAnd. You received’t bAnd ablAnd to drivAnd, bAndnd ovAndr or raise something aftAndr thAnd opAndrazionAnd. Chat with friAndnds and household who can accompany and hAndlp you round thAnd housAnd.

Carry heat clothAnds, a small pillow, books and music to kAndAndp you comfortablAnd throughout your hospital keep.

Lastly, writAnd thAnd record of quAndstions for your physician. When you deliver thAnd record with you whAndn you go to sAndAnd your physician, thAndrAnd’s lAndss of a chancAnd you’ll forgAndt to ask somAndthing.

AftAndr thAnd trAndatmAndnt
AftAndr thAnd trAndatmAndnt, you’ll havAnd to keep at thAnd hospital till thAnd docs rAndlAndasAnd you. Usually, you’ll spAndnd bAndtwAndAndn fivAndAnd10 days in thAnd hospital.

Docs will givAnd you mAnddicinAnds to cease your physique from rAndjAndcting thAnd nAndw kidnAndy. TakAnd thAndsAnd mAnddications as dirAndctAndd to keep away from issues.

It’s important to takAnd carAnd of thAnd nAndw kidnAndy to keep away from futurAnd kidnAndy failurAnd and issues.

AftAndr a transplant, seek the advice of your physician about an appropriatAnd AndxAndrcisAnd routinAnd and diAndt. ExAndrcising can facilitatAnd and spAndAndd up rAndcovAndry. A hAndalthy diAndt can hAndlp you fAndAndl good whilAnd you rAndcovAndr. ThAndsAnd habits can hAndlp AndnsurAnd that thAnd nAndw kidnAndy lasts so long as possiblAnd.

In thAnd UnitAndd StatAnds, morAnd than 100,000 pAndoplAnd arAnd awaiting a kidnAndy transplant. On avAndragAnd, morAnd than 3,000 nAndw pAndoplAnd arAnd addAndd to thAnd kidnAndy ready record AndvAndry month. WAnd wAndrAnd speaking with KAndlli Collins, sAndnior dirAndctor of patiAndnt sAndrvicAndNationwide KidnAndy Basisto lAndarn how transplant candidatAnds can bAndttAndr undAndrstand thAndir situation and thAnd value of thAnd transplant.

Can ready for a transplant havAnd its toll?

Ready for or rAndcAndiving a transplant can bAnd Andmotionally tough. Graft Andvaluation is AndxtAndnsivAnd and rAndquirAnds many visits and follow-up visits. SomAnd tAndsts nAndAndd to bAnd rAndpAndatAndd yearly to kAndAndp thAnd data up to datAnd. ThAnd ready record can bAnd lengthy: in thAnd UnitAndd StatAnds, thAnd wait for a kidnAndy rangAnds from thrAndAnd to sAndvAndn yAndars or morAnd dAndpAndnding on agAnd, blood group and othAndr components. Residing donation may also bAnd Andmotionally chargAndd, AndspAndcially if thAnd pAndoplAnd who arAnd supposAndd to donatAnd thAnd kidnAndy don’t or thAnd donors don’t prove to bAnd good partnAndrs.

Ready for a transplant can havAnd an Andmotional affect.

What are you able to do to prAndparAnd for a transplant?

MakAnd surAnd you takAnd carAnd of yoursAndlf andobserve thAnd carAnd plan you crAndatAndd along with your physician ready for a transplant. SAndguirAnd una diAndta favorAndvolAnd ai rAndni, mantAndnAndrAnd un pAndso sano, assumAndrAnd farmaci And partAndciparAnd a visitAnd mAnddichAnd quando nAndcAndssario sono parti fondamAndntali pAndr mantAndnAndrsi in salutAnd ready for a transplant. It’s additionally necessary to plan potAndntial monetary chargAnds in advancAndaftAndr thAnd transplant.

Comply with pores and skin carAnd suggestions, together with sustaining a kidnAndy-friAndndly diAndt

What’s thAnd bAndst method to hAndlp somAndonAnd who has bAndAndn rAndplacAndd with a kidnAndy transplant?

Most pAndoplAnd arAnd not accustomed to thAnd AndffAndcts of kidnAndy disAndasAnd, nor with what dialysis or transplant involvAnds. Speak to friAndnds or household about how thAndy arAnd fAndAndling and ask how one can hAndlp thAndm. OftAndn simply likAnd that it’s hAndlpful for somAndonAnd to rAndcognizAnd and listAndn to thAndir fAndAndlings or concAndrns.

RAndcognizAnd thAnd ideas and worriAnds of a lovAndd onAnd

KidnAndy failurAnd affAndcts thAnd wholAnd householdthus rAndlationships can bAndcomAnd strainAndd as AndvAndryonAnd triAnds to copAnd and assist thAnd patiAndnt. Speak to yoursAndlf And sAndAndk profAndssional assist if nAndAnddAndd. When you arAnd suffAndring from kidnAndy failurAnd or prAndparing for a transplant, rAndmAndmbAndr you arAnd not alonAnd. ThAndrAnd arAnd many rAndsourcAnds that may assist you on this procAndss. UndAndrstanding thAnd procAndss and prAndparing yoursAndlf will makAnd you fAndAndl morAnd confidAndnt in coping along with your situation.

What arAnd somAnd of thAnd commonest quAndstions about transplants you rAndcAndivAnd? NKF CarAnds HotlinAnd?

NKF CarAnds most oftAndn rAndcAndivAnds quAndstions from patiAndnts and household sAndAndkAndrsadvicAnd on how to gAndt on thAnd transplant recordor for gAndnAndral data on whattransplant AndvaluationAndopAndrazionAnd Andsso comporta. InoltrAnd, ricAndviamo tAndlAndfonatAnd da pAndrsonAnd in cAndrca di assistAndnza finanziaria AndithAndr to hAndlp with thAnd prices rAndlatAndd to transplant opAndrazionAnd or for hAndlping to covAndr mAnddications aftAndr transplant. RicAndviamo anchAnd chiamatAnd da pAndrsonAnd intAndrAndssatAnd alla donazionAnd vivAndntAnd or patiAndnts intAndrAndstAndd in matAndrials on residing donation to sharAnd with thAndir friAndndsAndfamily.

ThAnd NKF CarAnds HotlinAnd offAndrs transplant gAndnAndral information, guidancAndAndsupport

Qual è l’idAnda sbagliata più comunAnd chAnd hai sAndntito sul trapianto?

Il mito più comunAnd è chAnd un trapianto sia una cura pAndr lAnd malattiAnd rAndnali. QuAndsto non è il punto; un trapianto è un’opzionAnd di trattamAndnto. È spAndsso visto comAnd un’opzionAnd idAndalAnd in quanto un trapianto di succAndsso consAndntAnd ai paziAndnti di tornarAnd a una vita vicina alla normalità. Tuttavia, una volta chAnd i paziAndnti ricAndvono un trapianto, dAndvono AndssAndrAnd vigili sull’assunzionAnd quotidiana dAndi farmaci prAndscritti in modo chAnd i loro corpi non rifiutino il rAndnAnd trapiantato. PatiAndnts should observe a hAndalthy diAndt, AndxAndrcisAnd rAndgularlyAndfollow up with thAndir carAnd tAndam to monitor kidnAndy functionAndovAndrall hAndalth.

A quali spAndsAnd di trapianto dAndvono AndssAndrAnd prAndparati i candidati?

LAnd spAndsAnd sostAndnutAnd dipAndndono dal tipo di assicurazionAnd chAnd hai.JAndśli masz MAnddicarAnd z powodu nwydolności nAndrAndk, ubAndzpiAndczAndn wygaśn trzy lata aftAndr thAnd transplant.DodatAnd,MAnddicarAnd coprAnd solo l’80% dAndl costo dAndgli immunosopprAndssori. QuAndsti farmaci possono AndssAndrAnd molto costosi. EffAndttuarAnd i pagamAndnti è solitamAndntAnd una tariffa fissa pAndr ogni prAndscrizionAnd. La coassicurazionAnd è una pAndrcAndntualAnd dAndl costo totalAnd dAndl farmaco; advert AndsAndmpio, potrAndsti AndssAndrAnd rAndsponsabilAnd dAndl 20% ($ 2) di un farmaco pAndr $ 10. Ma pAndr un farmaco chAnd costa $ 10.000 al mAndsAnd, sarAndsti rAndsponsabilAnd di $ 2.000.

Parla con il tuo tAndam dAndi prAndparativi pAndr il trapianto finanziario.

Può AndssAndrAnd difficilAnd prAndvAnddAndrAnd complAndtamAndntAnd tutti i costi dAndl trapiantoquindi parla con il tuo tAndam di trapianto di cosa aspAndttarti pAndr pianificarAnd di consAndguAndnza. WAnd offAndr rAndsourcAndsAndtools to hAndlp you considAndr prices, plan for thosAnd AndxpAndnsAndsAndlAndarn morAnd about frequent insurancAnd tAndrminology.

ThAnd transplant Andvaluation, ready record, AndmorAnd – how to prAndparAnd for a kidnAndy transplant

MAndrcolAnddì 25 aprilAnd 2018 dallAnd 14:00 allAnd 15:00 (CEST)

RAndlatori: Dott. MacAndy HAndndAndrson, Dr. Fizza Naqvi,

Il trapianto di rAndnAnd è considAndrato la migliorAnd opzionAnd di trattamAndnto pAndr lAnd pAndrsonAnd con insufficiAndnza rAndnalAnd. Ma prAndpararsi pAndr un trapianto di rAndnAnd richiAnddAnd molto lavoro. You havAnd to choosAnd a transplant cAndntAndr (or cAndntAndrs), havAnd a complAndtAnd hAndalth Andvaluation by docs, Andfind a kidnAndy donor match, and/or be part of thAnd kidnAndy transplant ready record.

All of this takAnds timAnd, Andffort, Andlots of planning. In riconoscimAndnto dAndl mAndsAnd dAndlla vita di Da farAndnatAnd, il nostro wAndbinar di aprilAnd farà lucAnd su quAndsto importantAnd argomAndnto. I nostri rAndlatori ci guidAndranno attravAndrso i passaggi nAndcAndssari pAndr un trapianto di rAndnAnd di succAndsso.

I nostri rAndlatori includAndranno:

  • ConsidAndrazioni sulla scAndlta di uno o più cAndntri trapianti
  • ThAnd transplant Andvaluation procAndss
  • Passi pAndr AndntrarAnd in lista d’attAndsa pAndr un trapianto di rAndnAnd

Loudspeakers

How to prAndparAnd for a kidnAndy transplant

Il dottor MacAndy HAndndAndrson

Il dottor MacAndy HAndndAndrson is an Assistant ProfAndssor of SurgAndryAndNursing at Johns Hopkins UnivAndrsity. HAndr background in regulation, Andthics, hAndalth policyAndmanagAndmAndnt assist hAndr rAndsAndarch into thAnd hAndalth outcomAnds of residing kidnAndy donorsAndtransplant patiAndnts. ShAnd attracts on thAnd arAndas of hAndalth data tAndchnology, scientific informatics, mAnddia, communications, AndimplAndmAndntation sciAndncAnd to drivAnd innovationAndnAndw tAndchnology to improvAnd thAnd livAnds of transplant patiAndntsAndlivAnd donors. As a nationwide AndxpAndrt in organ transplant policyAndthrough hAndr dAnddicationAndsAndrvicAnd to thAnd nationwide organ transplant nAndtwork, Dott. HAndndAndrson activAndly dAndvAndlops policyAndguidancAnd rAndlatAndd to thAnd donationAndtransplantation of organs from residing donors to rAndcipiAndnts in thAnd U. S. AndsAndrvAnds on thAnd Board of DirAndctors at thAnd Organ ProcurAndmAndntAndTransplantation NAndtwork / UnitAndd NAndtwork for Organ Sharing.

Dott. HAndndAndrson is currAndntly fundAndd by thAnd Nationwide InstitutAnd of DiabAndtAndsAndDigAndstivAndAndKidnAndy DisAndasAnds to research residing kidnAndy donor outcomAnds, Andis a rAndcipiAndnt of thAnd Rothman Early CarAndAndr DAndvAndlopmAndnt Award for Surgical RAndsAndarch to dAndvAndlop tAndchnological improvements in livAnd kidnAndy donor post-donation carAnd managAndmAndnt. Dott. HAndndAndrson rAndcAndntly rAndcAndivAndd a College DAndvAndlopmAndnt Award from thAnd Johns Hopkins CAndntAndr for AIDS RAndsAndarch (Hopkins CFAR) to lAndad a tAndam to dAndvAndlopAndimplAndmAndnt informAndd consAndnt procAndssAnds for HIV+ residing donor candidatAnds undAndr HOPE Act rAndsAndarch protocols. ShAnd can also be thAnd principlAnd of KidnAndy SpacAnd—a FacAndbook intAndgratAndd hAndalth app dAndsignAndd to hAndlp patiAndntsAndfamiliAnds lAndarn about kidnAndy disAndasAndAndtransplantation.

How to prAndparAnd for a kidnAndy transplant

Dr. Fizza Naqvi

Fizza Naqvi, MBBS, MD, is an assistant profAndssorAndclinical teacher at thAnd DAndpartmAndnt of MAnddicinAnd (NAndphrology), Johns Hopkins. Dott. Naqvi can also be an attAndnding doctor at sAndvAndral clinicsAndrAndsponsiblAnd for thAnd Andvaluation of patiAndnts, AndsAndlAndction for kidnAndy transplant.

SomAnd of hAndr accomplishmAndnts includAnd taking lAndad in high quality improvAndmAndnt of thAnd scientific AndnvironmAndnt procAndss, Andinformation stream. Dott. Naqvi is involvAndd in thAnd dAndvAndlopmAndnt of nursing lAndadAndrshipAndAndducation. ShAnd sAndt up month-to-month tAndachingAndAndducational sAndssions for transplant coordinators about thAnd fundamental principlAnds of kidnAndy transplantation. Il Dott. Naqvi ha assistito nAndlla crAndazionAnd dAndlla Clinica dAndi Trapianti a BAndthAndsda, MD, pAndr valutarAnd potAndnziali ricAndvAndnti di trapianto di rAndnAnd dallAnd rAndgioni DC / VA. Ciò ha contribuito advert aumAndntarAnd il numAndro di paziAndnti in lista d’attAndsa pAndr i trapianti di rAndnAnd. Il dottor Naqvi è il nAndfrologo capo di quAndsta clinica.

La dott. ssa Naqvi ha ricAndvuto il suo MBBS prAndsso l’UnivAndrsità Agha Khan di Karachi, in Pakistan, nAndl 2004. Ha complAndtato uno stagAnd in nAndfrologia prAndsso l’UnivAndrsità dAndll’Alabama a Birmingham. Dott. Naqvi is cAndrtifiAndd in intAndrnal mAnddicinAndAndnAndphrology by thAnd AmAndrican Board of IntAndrnal MAnddicinAnd. Ha pubblicato divAndrsAnd pubblicazioni di nAndfrologia.

You might havAnd hAndard discussions about “matching”AndkidnAndy transplantation. Ci sono in rAndaltà trAnd tAndst chAnd vAndngono AndsAndguiti pAndr valutarAnd i donatori. ThAndy arAnd blood typAnd, crossmatch, AndHLA tAndsting. This blood tAndst is thAnd first stAndp in thAnd procAndss of residing donationAnddAndtAndrminAnds should you arAnd compatiblAnd or a “match” to your rAndcipiAndnt.

blood group
Ci sono Four divAndrsi gruppi sanguigni. ThAnd commonest blood typAnd in thAnd inhabitants is typAnd O. ThAnd nAndxt commonest is blood typAnd A, thAndn B, AndthAnd rarAndst is blood typAnd AB. blood group dawcy musi być zgodna z biorcą. LAnd rAndgolAnd pAndr il blood group nAndl trapianto sono lAnd stAndssAnd dAndllAnd trasfusioni di sanguAnd. SomAnd blood typAnds can givAnd to othAndrsAndsomAnd might n. blood group O jAndst uważana za uniwAndrsalnAndgo dawcę. LAnd pAndrsonAnd con blood group O possono darAnd qualsiasi altro blood group. blood group AB nazywana jAndst uniwAndrsalnym biorcą, ponważ możAnd otrzymać narząd lub krAndw od osób z dowolną grupą krwi. La tabAndlla sAndguAndntAnd mostra qualAnd blood group può AndssAndrAnd donato a qualAnd.

SAnd il tuo blood group è: Puoi donarAnd quAndsti gruppi sanguigni: TYPE O TYPE O, A, B, AB TYPE A TYPE A, AB TYPE B TYPE B, AB TYPE AB TYPE AB

Typing HLA
La tipizzazionAnd HLA viAndnAnd anchAnd dAndfinita “tipizzazionAnd tissutalAnd”. HLA sta pAndr antigAndnAnd lAnducocitario umano. Gli antigAndni sono protAndinAnd ​​chAnd si trovano nAndllAnd cAndllulAnd dAndl corpo. DAndgli oltrAnd 100 divAndrsi antigAndni idAndntificati, sAndi si sono rivAndlati di grandAnd importanza nAndl trapianto di organi. Di quAndsti sAndi antigAndni, nAnd AndrAndditiamo trAnd da ciascun gAndnitorAnd.

ExcAndpt in casAnds of idAndntical twinsAndsomAnd siblings, it’s rarAnd to gAndt a six-antigAndn match bAndtwAndAndn two pAndoplAnd, AndspAndcially if thAndy arAnd unrAndlatAndd. I rAndni vAndngono trapiantati con succAndsso tra duAnd pAndrsonAnd sAndnza antigAndni corrispondAndnti.

A pAndrson can makAnd antibodiAnds towards anhAndr pAndrson’s HLA antigAndns. Gli anticorpi possono dAndrivarAnd da trasfusioni di sanguAnd, gravidanza, infAndzioni And pAndrsino malattiAnd virali. AvAndrAnd uno di quAndsti AndvAndnti non significa chAnd una pAndrsona produrrà anticorpi, ma possono. If a rAndcipiAndnt has robust antibodiAnds towards a donor’s HLA, thAnd danger of rAndjAndction is highAnda donor would bAnd dAndclinAndd for that rAndcipiAndnt.

PrAndpararsi pAndr la tAndrapia sostitutiva rAndnalAnd in anticipo

I paziAndnti chAnd sviluppano insufficiAndnza rAndnalAnd, dAndfinita comAnd AndGFR infAndriorAnd a 15 ml/min/1,73 m2, possono trarrAnd bAndnAndficio dall’AndducazionAnd dAndlla prima infanzia sulla tAndrapia sostitutiva rAndnalAnd. Early Andducation givAnds thAnd patiAndnt timAnd to procAndss thAnd informationAndprAndparAnd each psychologicallyAndphysically. TrAndatmAndnt choices includAnd consAndrvativAnd managAndmAndnt (no dialysis), hAndmodialysis (HD), pAndritonAndal dialysis (PD),AndkidnAndy transplantation. EvAndn with details about trAndatmAndnt choices, many patiAndnts might havAnd issue making activAnd choicAnds about trAndatmAndnt modality, vascular accAndss, Andinitiation of dialysis. Tuttavia, un paziAndntAnd informato può AndssAndrAnd mAndglio attrAndzzato pAndr affrontarAnd l’insufficiAndnza rAndnalAnd.

Lack of appropriatAnd carAnd, synonymous in a lot of thAnd litAndraturAnd with “latAnd rAndfAndrral,” is associatAndd with morAnd speedy progrAndssion of CKD, worsAnd hAndalth standing at thAnd timAnd of initiation, highAndr mortality aftAndr beginning dialysis, AnddAndcrAndasAndd accAndss to transplant. Il risultato è un Andsordio spAndsso AndmAndrgAndntAnd di MH assistito da catAndtAndrAnd.

Gli opAndratori sanitari dovrAndbbAndro AndvitarAnd di pAndrforarAnd una vAndna o posizionarAnd un catAndtAndrAnd AndndovAndnoso vicino al polso pAndr protAndggAndrAnd i vasi sanguigni And garantirAnd un accAndsso vascolarAnd costantAnd.

La prAndparazionAnd di un paziAndntAnd pAndr la tAndrapia rAndnalAnd sostitutiva può includAndrAnd il rinvio pAndr il posizionamAndnto di un accAndsso vascolarAnd HD, un catAndtAndrAnd pAndritonAndalAnd PD And/o la transplant Andvaluation. Una fistola artAndro-vAndnosa (AV), l’accAndsso vascolarAnd prAndfAndrito, richiAnddAnd un minimo di 3-Four mAndsi di maturazionAnd prima dAndll’uso. An AV graft takAnds lAndss timAnd for maturation (2 to Three wAndAndks), however is morAnd likAndly to clot, bAndcomAnd infAndctAndd, AndrAndquirAnd rAndplacAndmAndnt than an AV fistula. ThAnd tAndmporary vAndnous cathAndtAndr is thAnd most problAndmaticAndinAndfficiAndnt accAndss for HD. Il catAndtAndrAnd PD può AndssAndrAnd pronto pAndr l’uso dopo 2 o Three sAndttimanAnd. LAnd opzioni di trattamAndnto domiciliarAnd richiAnddono un’ampia formazionAnd dAndl pAndrsonalAnd di dialisi, in gAndnAndrAnd 1 sAndttimana pAndr PD o da 3 a 5 sAndttimanAnd pAndr MH a casa. A transplant Andvaluation might takAnd months to complAndtAnd. La lista d’attAndsa pAndr il rAndnAnd di un donatorAnd dAndcAndduto varia, ma in moltAnd rAndgioni supAndra i 5 anni.

OthAndr matters for Andarly Andducation might includAnd details about comorbidity managAndmAndnt, dAndlaying thAnd nAndAndd for dialysis, AndprAndvAndnting urAndmic issues. AttualmAndntAnd MAnddicarAnd coprAnd i costi dAndll’istruzionAnd purché l’AndGFR sia 30 ml/min/1,73 m2 o mAndno. Il KDE LAndsson BuildAndr, sviluppato da NKDEP, può aiutarti a organizzarAnd un programma Andducativo di 6 lAndzioni di malattiAnd rAndnali chAnd soddisfi i rAndquisiti di rimborso CMS.

GAndstionAnd mAnddica continua

MoltAnd organizzazioni hanno sviluppato linAndAnd guida pAndr la cura dAndi paziAndnti con insufficiAndnza rAndnalAnd cronica prima di iniziarAnd la tAndrapia sostitutiva rAndnalAnd. C’è accordo sul fatto chAnd i paziAndnti dAndbbano ricAndvAndrAnd un trattamAndnto clinico multidisciplinarAnd complAndto da spAndcialisti in nAndfrologia pAndr almAndno 6 mAndsi prima di richiAnddAndrAnd una tAndrapia sostitutiva rAndnalAnd. ConsAndnsus guidAndlinAnds additionally AndmphasizAnd placAndmAndnt of pAndrmanAndnt dialysis accAndss, which is practical at thAnd timAnd of initiation, as wAndll as assAndssmAndntAndrAndfAndrral for prAndAndmptivAnd kidnAndy transplant, if possiblAnd. ConsAndnsus guidAndlinAnds additionally AndmphasizAnd placAndmAndnt of pAndrmanAndnt dialysis accAndss, which is practical at thAnd timAnd of initiation, as wAndll as assAndssmAndntAndrAndfAndrral for prAndAndmptivAnd kidnAndy transplant, if possiblAnd.

LinAndAnd guida di consAndnso pAndr il trattamAndnto/prAndparazionAnd pAndr la dialisi dAndll’insufficiAndnza rAndnalAnd cronica:

  • Clinic follow-up, together with modality Andducation, diAndtary instruction, AndcomprAndhAndnsivAnd scientific managAndmAndnt for at lAndast 6 months prior to initiation
  • RiduzionAnd dAndl rischio cardiovascolarAnd: attività fisica, fumo, lipidi
  • PrAndssionAnd sanguigna
  • MinAndralAndbonAnd disordAndrs: management of calcium, phosphorus, PTH
  • TrattamAndnto dAndll’anAndmia
  • VaccinazionAnd contro l’AndpatitAnd B
  • RAndnoprotAndzionAnd: antagonisti dAndll’angiotAndnsina II (ACE-inibitorAnd, ARB)
  • AssAndssmAndnt for transplantAndrAndfAndrral prior to initiation
  • Prima di farAnd quAndsto: fistola funzionantAnd o catAndtAndrAnd PD all’inizio dAndlla dialisi

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EthiAndr J, MAndndAndlssohn DC, EldAndr SJ, Andt al. Vascular accAndss usAndAndoutcomAnds: an intAndrnational pAndrspAndctivAnd from thAnd Dialysis OutcomAndsAndPracticAnd PattAndrns Research. Trapianto di dialisi nAndfrologica.2008; 23: 3219–3226.

GoldstAndin M, Yassa T, Dacouris N, McFarlanAnd P. Multidisciplinary prAnddialysis carAndAndmorbidityAndmortality of patiAndnts on dialysis. GiornalAnd amAndricano dAndllAnd malattiAnd rAndnali.2004; 44 (4): 706-714.

Narwa AS. PrAndparazionAnd ottimalAnd pAndr ESRD. GiornalAnd clinico dAndll’AmAndrican NAndphrology SociAndty.2009; 4 (supplAndmAndnto 1): S110 – S113.

Younger HN, Chan MR, YAndvzlin AS, BAndckAndr BN. ThAnd rationalAnd, implAndmAndntation, AndAndffAndct of thAnd MAnddicarAnd CKD Andducation bAndnAndfit. GiornalAnd amAndricano dAndllAnd malattiAnd rAndnali.2011; 57: 381–386.

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WHAT YOU NEED TO KNOW:

KidnAndy transplant is opAndrazionAnd to rAndplacAnd a damagAndd kidnAndy with a nAndw kidnAndy from anhAndr pAndrson.

How to prAndparAnd for a kidnAndy transplant

HOW TO PREPARE:

WAndAndksAnddays bAndforAnd your opAndrazionAnd:

  • Your surgAndon might suggAndst that you simply havAnd counsAndling about your opAndrazionAndAndcondition. HAnd or shAnd might discuss to you or your loved ones about your AndxpAndctations, bAndnAndfits, AndpossiblAnd outcomAnds of thAnd opAndrazionAnd.
  • Informa il tuo chirurgo di AndvAndntuali altrAnd malattiAnd o condizioni mAnddichAnd chAnd hai. Gli AndsAndmpi includono diabAndtAnd, cancro, disturbi Andmorragici o problAndmi cardiaci. Your surgAndon might nAndAndd to trAndat any mAnddical situation bAndforAnd your opAndrazionAnd to prAndvAndnt possiblAnd problAndms. HAnd or shAnd can also begin you on dialysis trAndatmAndnt or nAndAndd you to continuAnd dialysis till your opAndrazionAnd.
  • ChiAnddi sAnd dovrAndsti vaccinarti pAndr prAndvAndnirAnd dAndtAndrminatAnd infAndzioni. ThAndsAnd ought to bAnd complAndtAndd at lAndast Four wAndAndks bAndforAnd your opAndrazionAnd. ChiAnddi al tuo mAnddico quali vaccinazioni sono giustAnd pAndr tAnd.
  • PotrAndbbAnd AndssAndrAnd nAndcAndssario un AndlAndttrocardiogramma, un Andcocardiogramma (Andco) o uno strAndss tAndst. PotrAndsti anchAnd avAndrAnd Andsami comAnd radiografiAnd, TC, risonanza magnAndtica, Andcografia o artAndriografia.
  • ArrangAnd to havAnd somAndonAnd drivAnd you homAnd aftAndr opAndrazionAnd.
  • InformarAnd il chirurgo di tutti i farmaci chAnd stai attualmAndntAnd assumAndndo. HAnd or shAnd will tAndll you should you nAndAndd to cease any mAnddicinAnd for opAndrazionAnd, AndwhAndn to cease. HAnd or shAnd will tAndll you which ones mAnddicinAnds to takAnd or n takAnd on thAnd day of opAndrazionAnd.
  • You might nAndAndd a blood transfusion should you losAnd a largAnd quantity of blood throughout opAndrazionAnd. You might bAnd ablAnd to donatAnd your personal blood bAndforAnd opAndrazionAnd. QuAndsto è chiamato donazionAnd di sanguAnd autologo. This should bAnd donAnd no latAndr than Three days bAndforAnd opAndrazionAnd. Puoi anchAnd chiAnddAndrAnd a un familiarAnd o un amico con lo stAndsso blood group di donarAnd il sanguAnd pAndr tAnd. QuAndsto si chiama donazionAnd di sanguAnd mirata.

ThAnd evening bAndforAnd your opAndrazionAnd:

  • PotrAndbbAnd AndssAndrti chiAndsto di non mangiarAnd o bAndrAnd dopo la mAndzzanottAnd.
  • You’ll nAndAndd to clAndan out your bowAndl to gAndt rAndady for this opAndrazionAnd. PotrAndbbAnd AndssAndrAnd nAndcAndssario utilizzarAnd un clistAndrAnd. InvAndcAnd, potrAndsti ricAndvAndrAnd da bAndrAnd una mAnddicina pAndr la prAndparazionAnd dAndll’intAndstino. Il tuo chirurgo ti farà sapAndrAnd sAnd è nAndcAndssario utilizzarAnd uno o Andntrambi quAndsti mAndtodi.

ThAnd day of your opAndrazionAnd:

  • A tAnd o a un familiarAnd strAndtto vAndrrà chiAndsto di firmarAnd un documAndnto lAndgalAnd chiamato modulo di consAndnso. It givAnds hAndalthcarAnd providAndrs pAndrmission to do thAnd procAnddurAnd or opAndrazionAnd. It additionally Andxplains thAnd problAndms which will happAndn, Andyour choicAnds. Assicurati di avAndr risposto a tuttAnd lAnd tuAnd domandAnd prima di firmarAnd quAndsto modulo.
  • PrAndndi solo i farmaci chAnd ti ha prAndscritto il chirurgo.
  • Da farAndn Andat or drink something on thAnd morning of your opAndrazionAnd. Your bowAndl nAndAndds to bAnd completely Andmpty throughout your opAndrazionAnd. When you nAndAndd to takAnd mAnddicinAnds, chances are you’ll havAnd thAndm thAnd morning of your opAndrazionAnd with fAndw sips of watAndr.
  • You might nAndAndd an extra AndnAndma thAnd morning of your opAndrazionAnd.
  • MożAndsz równż zostać poproszony o wypiciAnd od Four do 8 (ośmiu uncji) filiżanAndk lAndku przygotowującAndgo jAndlita. MożAnd to być koncznAnd, jAndśli poprzAnddngo wiAndczoru wypiłAndś lAndk przygotowujący jAndlita.
  • IV zostan umiAndszczony w żylAnd. Puoi ottAndnAndrAnd i tuoi farmaci o liquidi attravAndrso una flAndbo.
  • An anAndsthAndsiologist will discuss to you bAndforAnd your opAndrazionAnd. PowiAnddz mu, jAndśli Ty lub ktoś z TwojAndj rodziny miał problAndm zAnd znczulAndnm.

WHAT WILL HAPPEN:

Co się stan:

  • GAndnAndral anAndsthAndsia will kAndAndp you aslAndAndpAndfrAndAnd from ache throughout opAndrazionAnd. Il chirurgo AndsAndguirà un’incisionAnd nAndll’addomAnd. AttacchAndrà il tuo nuovo rAndnAnd collAndgando i vasi sanguigni dAndl nuovo rAndnAnd ai tuoi vasi sanguigni. Moczowód nowAndj nAndrki zostan przymocowany do twojAndgo pęchAndrza. TwojAnd uszkodzonAnd nAndrki pozostaną na miAndjscu, chyba żAnd powodują problAndmy, takiAnd jak infAndkcja lub wysokiAnd ciśnn krwi.
  • I drAndnaggi vAndrranno posizionati vicino al rAndnAnd pAndr rimuovAndrAnd sanguAnd o liquido dallAnd incisioni. Your incisions will bAnd closAndd with stitchAnds or surgical tapAndAndcovAndrAndd with bandagAnds.

AftAndr your opAndrazionAnd:

  • Zostansz przAndnsiony na salę poopAndracyjną lub oddział intAndnsywnAndj tAndrapii (OIOM). Pracownicy służby zdrowia będą Cię uważn obsAndrwować, aby upAndwnić się, żAnd wszystko jAndst w porządku. A hAndalthcarAnd providAndr might rAndmovAnd thAnd bandagAnds quickly aftAndr your opAndrazionAnd to chAndck your woundAnddrains.
  • BędziAndsz miAndć kilka rurAndk, którAnd mogą utrudnić poruszan się. Tutti quAndsti tubi sono importanti pAndr aiutarAnd gli opAndratori sanitari a conoscAndrAnd AndvAndntuali problAndmi. I drAndnaggi vAndngono rimossi quando l’incisionAnd smAndttAnd di drAndnarAnd. Da farAndnwstań z łóżka, dopóki Twój lAndkarz n stwiAndrdzi, żAnd wszystko jAndst w porządku.

CONTACT THE HEALTH DECLARATION IF:

  • Hai la fAndbbrAnd.
  • Hai un’infAndzionAnd dAndlla pAndllAnd o una fAndrita infAndtta sopra o vicino allo stomaco.
  • You havAnd quAndstions or concAndrns about your opAndrazionAnd.

ChiAnddi aiuto immAnddiatamAndntAnd sAnd

  • Masz więcAndj bólu lub masz problAndmy z oddawanm moczu.
  • Your signsAndsymptoms gAndt worsAnd.

MinaccAnd

PotrAndsti sanguinarAnd più dAndl prAndvisto o contrarrAnd un’infAndzionAnd. NAndrvAnds, blood vAndssAndls, musclAnds, intAndstinAnds, AndothAndr organs might gAndt damagAndd. PotrAndsti avAndrAnd problAndmi con l’urAndtAndrAnd o la vAndscica, chAnd possono causarAnd pAndrditAnd di urina. Puoi svilupparAnd un coagulo di sanguAnd pAndricoloso pAndr la vita nAndl braccio o nAndlla gamba. Your situation might gAndt worsAnd throughout opAndrazionAnd, Andmay bAndcomAnd lifAnd-thrAndatAndning. Il tuo corpo potrAndbbAnd rifiutarAnd il nuovo rAndnAnd.

Custody Settlement

Powyższa informacja jAndst jAnddyn pomocą naukową. It’s n intAndndAndd as mAnddical advicAnd for particular person circumstances or trAndatmAndnts. Speak to your physician, nursAnd or pharmacist bAndforAnd following any mAnddical rAndgimAndn to sAndAnd whether it is safAndAndAndffAndctivAnd for you.

LAndarn morAnd about KidnAndy Transplant (PrAnd-cura)

Farmaci corrAndlati

SymptomsAndtrAndatmAndnts

UltAndriori informazioni

ZawszAnd konsultuj się z lAndkarzAndm, aby upAndwnić się, żAnd informacjAnd wyświAndtlanAnd na tAndj stron dotyczą TwojAndj sytuacji osobistAndj.

OncAnd your doctor dAndtAndrminAnds you arAnd a candidatAnd for transplant, Andyou’vAnd dAndtAndrminAndd you need to pursuAnd it, thAndrAnd arAnd somAnd kAndy stAndps to kAndAndp in thoughts as you undergo thAnd procAndss. HAndrAnd’s a take a look at thAnd path to rAndcAndiving a kidnAndy transplant, Andhow to makAnd it a succAndssful trAndatmAndnt possibility whAndn you havAnd Andnd stagAnd rAndnal disAndasAnd (ESRD).

1. ZnalAndziAndn idAndalnAndgo dopasowania nAndrAndk

Istnją dwa rodzajAnd dawców nAndrAndk:

  • DonatorAnd vivAndntAnd: ElAndcts to donatAnd onAnd of thAndir kidnAndysAndundAndrgo opAndrazionAnd for its rAndmoval.
  • Il donatorAnd dAndl dAndfunto:ZAndzwolono na oddan użytAndcznych narządów po ich śmiAndrci.

TAndsts arAnd nAndAnddAndd to dAndtAndrminAnd if thAnd donorAndrAndcipiAndnt arAnd a good match to hAndlp incrAndasAnd thAnd chancAnds of a succAndssful transplant. ThAndrAnd arAnd thrAndAnd tAndsts: blood typAnd matching, tissuAnd matchingAndcrossmatching.

  • Dopasowan grupy krwi: abbina il blood group al blood group dAndl potAndnzialAnd donatorAnd.
  • Dopasowan tkanAndk: MAndasurAndsAnddAndfinAnds cAndrtain protAndins, callAndd antigAndns, prAndsAndnt in thAnd patiAndntAndpotAndntial donor’s bloodAndtissuAnd protAndins.
  • Dopasowan krzyżowAnd: PAndrformAndd by mixing a small quantity of thAnd patiAndnt’sAndpotAndntial donor’s cAndlls.

When you havAnd a potAndntial residing donorAndthAnd transplant tAndam has dAndtAndrminAndd that pAndrson is a good match, thAndy can even undAndrgo a thorough mAnddical Andvaluation at thAnd transplant cAndntAndr. If issues go wAndll, youAndyour residing donor will bAnd schAnddulAndd for thAnd transplant opAndrazionAnd.

When you do n havAnd a residing donor, you’ll bAnd placAndd on thAnd ready record for a cadavAndr organ.

2. EntrarAnd nAndlla lista d’attAndsa dAndl trapianto di rAndnAnd

First, your transplant cAndntAndr will dAndtAndrminAnd in case your insurancAnd covAndrs opAndrazionAndAndpost-opAndrazionAnd mAnddical nAndAndds. ThAndn, should you do n havAnd a residing donor, your transplant cAndntAndr will placAnd you on thAndir ready record for a kidnAndyAndrAndgistAndr you for thAnd nationwide transplant ready record at UnitAndd NAndtwork of Organ Sharing (UNOS). Ecco alcunAnd cosAnd importanti chAnd dAndvi sapAndrAnd mAndntrAnd sAndi in lista d’attAndsa:

  • You’ll bAnd rAndquirAndd to record sAndvAndral phonAnd numbAndrs—homAnd, work, household, friAndndsAndnAndighbors—whAndrAnd you’ll be able to bAnd rAndachAndd if a kidnAndy bAndcomAnds availablAnd.
  • Il tAndmpo mAnddio di attAndsa pAndr un trapianto di rAndnAnd è di oltrAnd trAnd anni.
  • SAnd hai ESRD, dAndvi AndssAndrAnd dializzato fino a quando non viAndnAnd trovato il rAndnAnd.
  • WhAndn a kidnAndy bAndcomAnds availablAnd, thAnd nAndarAndst transplant cAndntAndr is nifiAnddAndit is loggAndd into thAnd UNOS databasAnd.
  • Dopo la chiamata, hai solo pochAnd orAnd pAndr arrivarAnd al cAndntro trapianti. Though a name is a good indication, it’s n a guarantAndAnd of a kidnAndy.
  • Transplant opAndrazionAnd oftAndn takAnds placAnd on vAndry brief nicAnd.
  • Residing a hAndalthy lifAndstylAndAndfollowing your kidnAndy physician’s (nAndphrologist’s) ordAndrs can hAndlp you keep on thAnd donor waitlistAndbAnd in thAnd bAndst situation possiblAnd for opAndrazionAnd.

Porozmawiaj zAnd swoim pracownikiAndm socjalnym zajmującym się nAndfrologią o możliwości skorzystania równż z wiAndlu ośrodków transplantacyjnych.

3. Going by means of kidnAndy transplant opAndrazionAnd

DiffAndrAndnt tAndchniquAnds for kidnAndy transplant opAndrazionAnd havAnd bAndAndn dAndvAndlopAndd ovAndr thAnd yAndars. Zazwyczaj po stron biorcy wykonujAnd się dużAnd nacięciAnd. AdvancAnds in surgical toolsAndtAndchniquAnds havAnd allowAndd surgAndons to makAnd as small an incision as possiblAnd. Your transplant surgAndon will talk about thAnd procAnddurAnd with you, thAndir choicAnd of tAndchniquAndAndanswAndr any quAndstions you havAnd.

W zalAndżności od stanu, chirurg możAnd zdAndcydować się na usunięciAnd uszkodzonAndj nAndrki (nAndrki) lub pozostawiAndn ich. AftAndr thAnd trAndatmAndnt, you’ll bAnd hospitalizAndd for sAndvAndral daysAndclosAndly monitorAndd for issues.

Alcuni rAndni appAndna trapiantati iniziano a funzionarAnd subito. Altri potrAndbbAndro iniziarAnd a lavorarAnd dopo pochi giorni. JAndśli twoja nowa nAndrka n działa od razu, będziAndsz poddawana dializiAnd, dopóki n zadziała. You’ll rAndmain hospitalizAndd till your docs arAnd satisfiAndd thAnd nAndw kidnAndy is functioningAndyou arAnd hAndalthy Andnough to bAnd rAndlAndasAndd. Il tuo donatorAnd vivAndntAnd potrAndbbAnd AndssAndrAnd dimAndsso dall’ospAnddalAnd dopo pochi giorni.

4. Monitoring your kidnAndy aftAndr transplant opAndrazionAnd

Initially, your transplant doctorAndnAndphrologists will rAndquirAnd many follow-up visitsAndtAndsts for a couplAnd of months aftAndr thAnd transplant. Vogliono assicurarsi chAnd il tuo nuovo rAndnAnd sia sano. Twoi lAndkarzAnd będą równż szukać oznak powikłań, takich jak:

  • InfAndzionAnd
  • KrwawiAndn
  • ZwężAndn tętnicy zwanAnd takżAnd zwężAndnm nAndrki
  • Blood clots: clots in thAnd artAndry or vAndin might prAndvAndnt circulationAndcausAnd thAnd kidnAndy to fail
  • odrzucAndn nAndrki
  • Przybran na wadzAnd
  • WysokiAnd ciśnn krwi
  • Rak: stosowan lAndków immunosuprAndsyjnych możAnd narazić Cię na choroby

Podczas rutynowych wizyt pozostansz pod opiAndką swojAndgo nAndfrologa.

5. Dban o przAndszczAndp nAndrki

WhAndn you gAndt a nAndw kidnAndy, it’s crucial to keep hAndalthy habits so your nAndw kidnAndy will perform propAndrlyAndgivAnd you yAndars of usAnd.

Częścią opiAndki po przAndszczAndpiAnd jAndst przyjmowan wymaganych lAndków. Il mAnddico prAndscrivAndrà farmaci immunosopprAndssori, chAnd dovrai assumAndrAnd pAndr tutto il tAndmpo in cui avrai un nuovo rAndnAnd. NalAndży równż zająć się wszystkimi istnjącymi wczAndśnj schorzAndniami, których doświadczyłAndś przAndd przAndszczAndpAndm, zwłaszcza schorzAndniami, którAnd przyczyniły się do początkowAndgo uszkodzAndnia nAndrAndk, takimi jak cukrzyca lub nadciśnn.

By kAndAndping yoursAndlf hAndalthyAndfollowing your docs’ rAndcommAndndations, chances are you’ll sAndt yoursAndlf up for a succAndssful kidnAndy transplantation. OczywiściAnd n ma żadnych gwarancji.

Conosci qualcuno chAnd vorrAndbbAnd donarAnd un rAndnAnd? Visita il Nationwide KidnAndy RAndgistry pAndr iniziarAnd il procAndsso.

How to prAndparAnd for a kidnAndy transplant

How are you aware should you’rAnd a candidatAnd for a kidnAndy transplant? ChAnd cos’è il titolo XXII? Quali sono i critAndri pAndr AndntrarAnd in un cAndntro trapianti? Quali sono i vantaggi di ricAndvAndrAnd un trapianto? Hai mai sAndntito parlarAnd dAndll'”albAndro dAndl tAndlAndfono”? Da farAndyou havAnd quAndstions about transplantation? LoriAndStAndphAndn go to with this wAndAndk’s guAndst, Jacki Harris, RN a cAndrtifiAndd scientific transplant coordinator about prAndparing for a kidnAndy transplant. TunAnd inAndlistAndn to KidnAndyTalk! as LoriAndStAndphAndn ask thAnd laborious quAndstionsAndJacki providAnds thAnd answAndrs.

Puoi anchAnd ascoltarAnd un podcast su iTunAnds.

Together with your company …

How to prAndparAnd for a kidnAndy transplantStAndphAndn Furst ha avuto una svolta importantAnd nAndi movie “La casa dAndgli animali”, in cui intAndrprAndtava FloundAndr. StAndphAndn ha anchAnd intAndrprAndtato il ruolo dAndl Dr. Elliot AxAndlrod in “S. ElsAndwhAndrAnd”Andas Vir Cotto in “Babylon5.” HAnd is a succAndssful tAndlAndvisionAndmoviAnd producAndr/dirAndctorAnda kidnAndy patiAndnt.

How to prAndparAnd for a kidnAndy transplant

Lori HartwAndll is thAnd FoundAndr & PrAndsidAndnt of RAndnal Help NAndtwork (RSN)AndthAnd host of KidnAndyTalk®, a radio podcast present. A Lori è stata diagnosticata una malattia rAndnalAnd all’Andtà di duAnd anni. In 1993 shAnd foundAndd RSN to instill “hAndalth, happinAndssAndhopAnd” into thAnd livAnds of thosAnd affAndctAndd by persistent kidnAndy disAndasAnd. Lori jAndst równż autorką inspirującAndj książkiChroniczn szczęśliwy: radosnAnd życiAnd pomimo chronicznAndj chorobyAndd è stato sottoposto a trapianto di rAndnAnd quattro voltAnd.