目的：高齢

方法：「日本肝移植研究会」に登録された移植実施施設67か所のうち，18施設の移植コーディネーターや医師に研究協力を依頼した．協力が得られた7施設で外来受診時の65歳以上の生体肝移植

結果：91.6%の

結論：高齢

生体腎移植手術によって

In Japan, there has been a confirmation system for a registered recipient transplant coordinator (RTC) since 2011. However, a systematic educational system for RCTs has not been established yet. An inter-institutional training program for RCTs among a limited number of University hospitals was made and conducted with the aid of financial support by the Ministry of Education, Culture, Sports, Science, and Technology (MEXT) from 2014 to 2019. It was a part of the whole program applied by the Kumamoto University Hospital to train liver transplant professionals including surgeons and pathologists. In total, eight trainees, who were all active registered nurses in the university hospitals, enrolled to the program. The curriculum was set as one year for each trainee, and consisted of lectures, web conferences, and on-site learning among the different institutions. Some lectures were held combined with the congress of related academic societies to save the time for learning.

It was hard to recruit the trainees because the program had no incentives and no official confirmation for the completion of the program. However, this program could enhance the motivation of not only each trainee but also the currently working RCTs in charge of instruction. On-site training in different institutions was effective to realize the practice, and also could build an inter-institutional community of RCTs and trainees, or future RCTs. This first trial to make such an educational system for RCTs in Japan was introduced in the Congress of the Asian Society of Transplantation in 2017.

In conclusion, this prototype of a training system for RCTs in Japan was effective to increase reserves for the next generation concurrent with the formation of an intimate communication system. However, a more strict and permanent system is necessary to create more standardized qualified RCTs authorized with an official or public confirmation.

【Objective】We aimed to clarify the usefulness of nursing intervention by exploring psychological experiences of adult living-donor liver transplant recipients during their hospitalization period in this study.
【Design】This was a category study.
【Methods】We interviewed living-donor liver transplant recipients with their consent. In a semi-structured format, we asked about their psychological experiences during hospitalization, and then analyzed the meaning of their experiences.
【Results】The recipients (n=11) had postoperative feelings of "escape from intolerable confusion," "reassurance provided by the obligatory situation," "complicated emotions when thinking of donors" before the operation and "hallucinations and trouble discerning reality," and "greater suffering than expected." Prior to hospital discharge, the recipients had felt "elevated motivation resulting from the pleasure derived from improved recovery and receiving support". These six feeling categories consisted of 19 subcategories.
【Conclusion】The present results suggest the need, for postoperative recovery to widely accept the postoperative difficulties and suffering that recipients face. Nurses evidently can help the recipients acquire self-care abilities by understanding their suffering and facilitating their ability to speak their mind.

（目的）平均寿命の延長に伴い肝移植

【目的】

幼少期に肝移植を受けた

【方法】

医中誌、PubMed、CINAHL、MEDLINEでキーワードを「小児」「肝移植」「自己管理」「Child」「Liver Transplantation」「Self-Management」「Self Care」とし、2010年1月1日～2023年6月30日までの期間で検索し、7つの文献が分析対象となった。

【結果】

分析対象の文献で用いられていた尺度は、責任の割り当て（Allocation of Responsibility）、責任と病気の理解度調査（the Responsibility and Familiarity with Illness Survey）、 発達による健康マネジメント能力チェックリスト（Developmentally Based Healthcare Management Skills Checklist）、健康能力チェックリストツール（the Healthcare Skills Checklist Tool）、包括的アセスメント測定 （Global Assessment Measure）、移行準備調査：思春期・若年成人期版（Transition Readiness Survey: Adolescent/Young Adult Version）であった。しかし、これらの尺度は必要な健康管理を親管理から

【結論】

今後は日本の医療体制を踏まえて、看護師が親管理から小児肝移植

目的：

目的：生体肝移植成人

方法：肝

結果：7名の調査協力があった．認識では7カテゴリーと26サブカテゴリーが生成され【生体肝移植前における他の外科系手術の術前看護との相違】【

結論：肝

Since central pontine myelinolysis (CPM) is a demyelinating disease of the pons that is commonly associated with neurological disorders, if it occurs post-transplant in organ recipients, a comprehensive support system including rehabilitation and holistic care should be established. Here, we report our experiences of recipient transplant coordinators (RTC) in promoting cooperation among transplant providers for smooth implementation of the support system.

【Case presentation】 A 60-year-old female patient with acute liver failure with hepatic coma received liver transplantation from a deceased donor. Ten days after transplantation, she developed a neurological disorder, including impaired consciousness and respiratory muscle paralysis. She was diagnosed with CPM, which was possibly associated with immune-suppressive drugs. As a result, the calcineurin inhibitor was switched to everolimus. To restore neurological function, multidisciplinary approaches were implemented, with RTCs promoting cooperation among transplant providers. The RTCs also motivated the recipient to continue her physical rehabilitation. Their positive attitude allowed the patient, as well as the family, to feel relieved from mental distress during the post-transplant period. Although the recipient’s neurological function improved, she required assistance in her activities of daily living. Therefore, the RTCs coordinated the discharge of the recipient to a rehabilitation facility capable of caring for her. The recipient was discharged 140 days after transplantation.

【Conclusion】 It is important to provide holistic supportive care for recipients with neurological disorders due to CPM. RTCs can play a pivotal role in promoting cooperation among transplant providers.

生体腎移植における

脳に埋没しているM3遠位部の非囊状動脈瘤に血行再建術を行う場合，