Renal transplant recipients in the integrated community care

Abstract

With the advances in medical technology centering on immunosuppressive therapy, the long-term survival of kidney transplant recipients has increased. We are now seeing cases in which such patients, while maintaining their transplanted kidney function, have aged to a point where they have developed dementia or found themselves bedridden and in need of nursing care. When it comes to transplant patients, there are limits in terms of transplant centers and other acute care facilities regarding their hospitalization. There are also imposed limitations on accepting such patients in recuperation wards and other care facilities. Thus, we can hardly say the environment is set up to receive transplant patients. If kidney transplants are becoming part of standard medical practice, such transplant patients must be accepted into the integrated community care system, where they would be able to receive housing, medical care, nursing care, preventive care, and livelihood support provided in a cohesive manner. However, there are limits to how much a transplant center can do in addressing such issues while being responsible for handling acute medical care needs. All the while, there is a growing need for coordination with the primary care physician； hospital transfers with due consideration for differentiated functions of the medical facilities, home healthcare, and nursing care services；utilization of social resources including nursing homes and facilities；and cooperation with the government. To this end, it is also important for the transplant side to be engaged in awareness-raising activities by sending society the message, “Kidney transplants are nothing special.”