Coping with transplant failure: grief vs. denial. 1983

J Streltzer, and M Moe, and E Yanagida, and A Siemsen

A major drawback to kidney transplantation as a treatment for end stage renal disease is the common occurrence of rejection and failure of the transplanted kidney. We evaluated twenty-five dialysis patients, all of whom had suffered transplant failure during a ten year period. Of these, twenty-four had good psychological readjustment to chronic dialysis. Fourteen patients successfully grieved the loss of their kidneys. Ten denied any psychological difficulty in returning to dialysis and did not manifest the usual signs of grief. We suggest that the effectiveness of denial as a coping mechanism should be recognized and supported when present; in contrast, "grievers" should be helped through the grieving process and followed up to ensure resolution and proper readjustment to dialysis.

UI MeSH Term Description Entries
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011581 Psychological Tests Standardized tests designed to measure abilities (as in intelligence, aptitude, and achievement tests) or to evaluate personality traits. Parenting Stress Index,Trier Social Stress Test,Trier Stress Test,Psychologic Tests,Psychological Test,Test, Psychological,Tests, Psychological,Index, Parenting Stress,Psychologic Test,Stress Index, Parenting,Stress Test, Trier,Test, Psychologic,Test, Trier Stress,Trier Stress Tests
D003717 Denial, Psychological Refusal to admit the truth or reality of a situation or experience. Denial, Psychology,Psychological Denial
D006084 Graft Rejection An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. Transplant Rejection,Rejection, Transplant,Transplantation Rejection,Graft Rejections,Rejection, Graft,Rejection, Transplantation,Rejections, Graft,Rejections, Transplant,Rejections, Transplantation,Transplant Rejections,Transplantation Rejections
D006117 Grief Normal, appropriate sorrowful response to an immediate cause. It is self-limiting and gradually subsides within a reasonable time. Mourning,Griefs,Mournings
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000223 Adaptation, Psychological A state of harmony between internal needs and external demands and the processes used in achieving this condition. (From APA Thesaurus of Psychological Index Terms, 8th ed). Behavior, Adaptive,Healthy Adaptation,Positive Adaptation,Psychological Recovery,Adaptation, Psychologic,Adjustment,Psychological Adaptation,Adaptation, Healthy,Adaptation, Positive,Adaptive Behavior,Adaptive Behaviors,Healthy Adaptations,Positive Adaptations,Psychologic Adaptation,Psychological Recoveries,Recovery, Psychological

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