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With case examples and step-by-step frameworks for intervention, the authors illustrate the challenges and solutions in establishing an effective ward-based psychotherapy service for renal dialysis and transplant patients. They describe clinical patterns of presentation and how psychotherapeutic intervention was refined over time in a clinically meaningful and evidence-based manner. Each chapter is focused on specific emotional disorders among renal patients. The authors introduce the concept of loss of an imagined past' (aspirations and ambitions) never realized, or compromised, as a result of renal disease and as a major cause of post-transplant depression. Emotional issues which have received little prior attention in the literature--including substance abuse, eating disorders, gender disorders and emotional body image--are addressed in depth. Practical advise, including that against referencing the transplanted organ as "a gift," is offered.
The first part of the book narrates the story of a single mother from Georgetown in Guyana who made an appeal to help her son dying of kidney failure to obtain a kidney transplant which was not available in their country. They needed help to travel to India to get the transplant. The flyer appealing for help lands in the hands of a Guyanese-American, George Subraj, who is intrigued by this appeal. He seeks the help of Indian-born Transplant Surgeon, Dr. Rahul M. Jindal, who, in turn, organizes a medical team to perform the surgery. This is also a story of how Americans come together to save the life of a young man in Guyana, whose determined single mother refused to give up. In the second part of the book, the social aspects of transplantation are discussed which include medical compliance, anxiety and depression in kidney transplant recipients and social networks pertaining to kidney transplantation. In the third part of the book, the economics of kidney transplantation in developing countries are discussed, along with the economics of peritoneal versus hemodialysis, pre-emptive kidney transplantation for developing countries, health policy for treating renal failure in developing countries and finally commercialization of kidney transplantation - a problem which is increasing world-wide.
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