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On February 6, two earthquakes occurred in Kahramanmaraş-Pazarcık (7.7) and Elbistan (7.6) in Turkey. In this earthquake, 13.5 million people were affected and 41 thousand 156 people died until 21.02.2023.The COVID-19 pandemic, which has recently affected the whole world, has also greatly affected transplantation. During the first wave of the pandemic, living donor kidney transplant activity was reduced or temporarily suspended for various reasons (Sever, M. S; 2022). 23% of centers reported a significant decrease in assessments (Salvalaggio, 2021). It has been argued that the Covid pandemic has also affected the statistics on organ transplantation in our country. According to the data of the TR Ministry of Health, it has been determined that the number of transplants in our country, the number of live and cadaveric kidney and liver transplants, and the total organ transplants have decreased in 2020 and 2021 due to the Covid-19 pandemic. The number of organ donations decreased to 124720 in 2019 and to 25059 in 2020. PMP values (pmp : per million population) of all regions showed a significant decrease. It is estimated that the earthquake disaster will have a negative impact on organ transplantation, like the COVID-19 pandemic.It is thought that with the impact of 11 provinces due to the earthquake disaster in our country. As the health care system is affected, we anticipate that especially the transplant-ayson service will be affected much more in this phase and the negative impact will increase further in the coming months. In this study, it is planned to present 6-month data on the post-earthquake organ tx numbers from living to deceased donors, organ donation ratio, obtaining an organ donation volunteer card, pmp numbers, the follow-up of existing patients in the earthquake zone, organ tx studies carried out in the earthquake zone, Ministry of Health and healthcare professionals activities to reduce impact in the transplant field during and after a disaster and in this study.

There are sex and gender disparity in kidney transplantation. This disparity varies between countries and regions. Bu nedenle Dünya’da en fazla uygulanan böbrek transplantasyonunda cinsiyet eşitsizliğinin tüm bölgeleri içerek şekilde ele alınmasına gereksinim vardır. Transplantasyonda cinsiyet eşitsizliğinin öncelikle transplantasyona neden olan organ yetmezliği görülme durumu ve nedeni, organ yetmezliği sonrası tedaviye erişim, transplantasyona erişim olarak ele alınmaktadır. Transplantasyona erişimde, canlı verici olma, canlı vericiden transplantasyon olma (alıcı), ölü verici bekleme listesine erişim (alıcı adayı), ölü verici olma ve ölü vericiden nakil olma (alıcı) ele alınmalıdır. Ayrıca, transplantasyon sonrası cinsiyetin sağkalım oranı ve süresi, graft sağkalım ve süresi, hastalık nüksü, rejeksiyon gelişme oranı ve sıklığı gibi transplantasyon sonuçlarına etkiside incelenen değişkenler arasındadır. Transplantasyonda ana eşitsizliğin bekleme listesine erişimde olduğunu vurgulanmaktadır (Melk ve ark. 2019; Couchoud ve ark. 2012). Bekleme listesinde cinsiyet eşitsizliğini biyolojik faktörlerden daha çok sosyoekonomik faktörlerin etkili olduğu belirtilmektedir (Melk ve ark. 2019). Bu eşitsizlikte yaşın önemli bir faktör olduğu vurgulanmaktadır. Özellikle kız çocuklarının ve yaşlı kadınların böbrek transplantasyonuna erişiminin çok daha az olduğu belirtilmektedir. Tüm Dünyada bu konuda duyarlılık kazandırılması için transplantasyon alanında çalışan sağlık profesyonellerinin uluslararası toplantılarda bu konunun ele alınması ve tartışılması gerekir. According to the data of 2021 in a systematic review, 38% of women and 62% of men are on the kidney transplant waiting list. In kidney transplantation, while the rate of women is 39%, the rate of men is 61% (Salas et al.,2022). A French study evaluated 9497 men and 5386 women aged 18 to 74 years who started dialysis between 2002 and 2009. It shows that women are less likely to enroll in the national transplant waiting list and the time from start of dialysis to registration is longer (Couchoud et al. 2012). In a study conducted in India, 831 donor kidney transplant recipients were 68% male and 32% female between 1997 and 2018, and between 2000 and 2020, 79% of donors were female and the overwhelming majority (80%) of recipients were male (Kute et al. 2022). In a study conducted in Turkey, 57.8% of the donors were women in kidney transplants performed between 1985 and 2017; It was determined that 74.7% of the recipients were male (Mıhçıokur et al. 2019). Education programs should be organized primarily to raise awareness about gender disparity in transplantation. There is a need to identify the factors contributing to gender disparity in kidney transplantation and to conduct research on preventive interventions. Policies and procedures should be developed and implemented to ensure equal access for men and women in transplant centers

Background: The SystemCHANGETM intervention harnesses patients’ established daily routines/habits, environment, and important others, as possible solutions that are reoccurring and thus reliable systems that could support medication taking to become a dependable routine/habit. The aim of this study was to evaluate the effect of a six -month SystemCHANGE™ intervention compared to a six-month attention-control education intervention on medication adherence and quality of life in kidney transplant recipients. A six-month maintenance phase where the intervention was withdrawn was also evaluated.Methods: A randomized controlled trial single-blind (participants) study design was used. After screening for 3 months using electronic monitoring, participants with medication adherence (>.85) were excluded from the study while those with medication nonadherence (TM intervention (n= 21) and the attention control group (n= 21) received the 6-month patient education intervention. The maintenance phase continued for six months afterwards. Electronic monitoring was used to measure medication adherence.Results: At the completion of the six-month intervention phase, there was a statistically significant difference in medication adherence between the SystemCHANGETM (median 0.97, IQR 0.93 -0.98) and attention control (median 0.81, IQR 0.71-0.87) groups (U= 4.190, p< .001). At the completion of the 6-month maintenance phase, the statistically significant difference was maintained between the SystemCHANGETM (median 0.94, IQR 0.81-0.96) and attention control (median 0.76.00, IQR 0.69-0.86) groups (U= 2.843, p< .004, Table 1, Figure 1). There was no difference in the quality of life between groups (p> 0.05).Conclusion: This study, which had a strong research design, showed that the SystemCHANGE™ intervention was effective in improving patients' medication adherence and outcoes.

BACKGROUND: The purpose of this study was to evaluate the risk factors affecting psychosocial outcomes of living liver donors after liver transplantations. METHODS: This was a descriptive, cross-sectional study. The sample consisted of living liver donors followed by 2 liver transplantation centers in 2 private hospitals in 2 different provinces, between August 2017 and October 2019. All the living liver donors were contacted without a time frame after donation and all the participants were evaluated once. The Beck Depression Scale, SF-36, General Self-Efficacy Scale, and Perceived Available Support Scale were used to collect data. The t-test, Kruskal–Wallis test, Mann–Whitney U-test, and Pearson correlation analysis were used for data analysis. RESULTS: The mean age of the patients was 34.31 ± 8.22 years. There was a positive, weak correlation between age and physical function. Gender, marital status, financial status, and education levels significantly affected physical components, social function, vitality, depression, and self-efficacy scores. High depression levels negatively affected the physical component, self-efficacy, and social support scores of the living liver donors. High self-efficacy positively affected social support. CONCLUSION: The study revealed that gender, marital status, employment status, and education levels were associated with psychosocial outcomes. The financial status was the main factor affecting each psychosocial variable. Financial status needs to be assessed in detail before and after the operation.

Amaç: Araştırma böbrek nakli alıcılarında beslenme ve fiziksel aktivite durumlarını etkileyen faktörlerin incelenmesi amacıyla yapılmıştır.Yöntem: Çalışma tanımlayıcı ve kesitsel bir araştırmadır. Bu araştırma bir özel hastane ve bir üniversite hastanesinde böbrek nakli polikliniğinde izlemleri devam eden alıcılarla (n=107) Ağustos 2017-Ağustos 2018 tarihleri arasında gerçekleştirilmiştir. Veriler sosyodemografik ve klinik özellikler formu, beslenme durumu değerlendirme anketi ve Uluslararası Fiziksel Aktivite Ölçeği kullanılarak elde edilmiştir. Verilerin analizinde, t-testi, Mann-Whitney U testi ve Pearson korelasyon analizi kullanılmıştır.Bulgular: Hastaların yaş ortalaması 47.01±13.78 olarak bulunmuştur. Hastaların fark Beden Kütle İndeksi (BKİ) puan ortalaması 2.44±4.78 olarak bulunmuştur. Hastaların nakil sonrası ilk ve son izlem; ağırlıkları ve BKİ değerleri arasında istatistiksel açıdan ileri düzeyde anlamlılık bulunmuştur (p0.05). Fark BKİ puan ortalamaları ile fiziksel aktivite düzeyleri arasında ilişki bulunamamıştır (p>0.05). Sonuç: Çalışmamızda fark BKİ değerine göre yapılan analiz sonucunda, yaş ilerledikçe hastaların daha az kilo aldıkları ve nakil sonrası geçen zaman arttıkça daha fazla kilo aldıkları belirlenmiştir. Hastaların sosyodemografik ve klinik özelliklerinin fiziksel egzersiz düzeyini etkilemediği bulunmuştur. Ayrıca, hastaların kilo alma durumları ile fiziksel egzersiz düzeyleri arasında ilişki olmadığı bulunmuştur. Hastaların kilo alma ve fiziksel egzersiz durumlarının ileriye dönük olarak belli aralıklara incelenmesine gereksinim vardır. Anahtar sözcük: Böbrek nakli, beslenme, fiziksel aktivite. Aim: The aim of the study was to investigate factors affecting kidney transplant recipients' nutrition and physical activity between the first and last follow-ups after transplantation.Methods: This is a descriptive and cross-sectional study. The population of the study consisted of patients with kidney transplantation at one private and one educational research hospitals. The study sample included 107 people. The study data were collected by using the sociodemographic and clinical characteristic form, nutrition assessment questionnaire, and International Physical Activity Scale. The t-test, Mann-Whitney U test and correlation analysis were used to evaluate the data.Results: The mean age of the recipients was 47.01±13.78. The results of the analysis demonstrated that the difference between the mean BMI scores determined at the first and follow-ups was 2.44±4.78. There were statistically significant differences between the weight and BMI values determined at the first and last follow-ups after transplantation of recipients (p0.05).Conclusion: In this research, the analysis were made in accordance with the difference between the two BMI scores. While the recipients gained less weight as age progressed, they gained more weight as the time elapsed after kidney transplantation increased. Sociodemographic and clinical characteristics of the recipients did not affect their physical exercise levels. In addition, no correlation was found between the weight gain and physical exercise levels of the recipients. Weight gain and physical activity status of recipients should be examined periodically.Key words: Kidney transplant recipients, nutrition, physical activity. 70