Aspects of Self-Management After Solid Organ Transplantation-A Scoping Review

Abstract

Background: Solid organ transplantation improves survival and quality of life but requires lifelong self-management. While models exist for kidney and liver recipients, a comprehensive framework for all solid organ transplant recipients is lacking. Addressing this gap is essential for optimizing post-transplant care. Objectives: This report aims to conceptualize self-management after solid organ transplantation by addressing questions related to (1) the contexts studied to date, (2) research methodologies and publication types used, and (3) core aspects associated with self-management post-transplantation. Methods: A scoping review was used to address the above objectives. A comprehensive search strategy identified relevant studies, followed by systematic screening, data extraction, and qualitative content analysis. Findings were categorized using a deductive-inductive coding approach to map core self-management aspects after solid organ transplantation. Results: The search yielded 34,417 records, with 742 ultimately included. Publications from 43 countries spanned 43 years, with many (48.9%) published after 2016. Research articles dominated (80.1%), covering kidney (61%), liver (22%), heart (21%), and lung (16%) transplants. A qualitative analysis identified four self-management domains containing various categories: (1) Managing the medical-therapeutic regimen, (2) managing biographical work, (3) managing (new) life roles, and (4) generic self-management skills. The conceptual model illustrates their interconnections, with aspects of the medical-therapeutic regimen management most frequently covered. Conclusions: Self-management after solid organ transplantation is complex, involving medical-therapeutic, emotional, social, and behavioral aspects. Aspects of managing the medical-therapeutic regimen dominate the research literature, while other aspects need further exploration. Future studies should address gaps to support holistic, patient-centered post-transplant care strategies.

Keywords: conceptualization; scoping review; self-management; solid organ transplantation.

Figure 1

Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow diagram for the screening and selection process in the Scoping Review.

Figure 2

Number of included documents included in the ScR by year of publication (N = 742). Legend: Q1: 1st quartile; Q3: 3rd quartile.

Figure 3

Number of included documents by origin (world region) (N = 742). Legend: Created with MapChart.net.

Figure 4

Conceptual model of self-management of adults following solid organ transplantation. Legend: N indicates the number of documents with corresponding content; icon graphics were obtained from Freepik, fzyn, Kiranshastry, Smashicons and srip via www.flaticon.com.

Figure 5

Content coverage of the category system according to organ entity and publication date. Legend: Tx: Transplantation; SOTx: Solid organ transplantation.

Figure 6

Content coverage in relation to the main domains.