Non-adherence in pediatric liver transplant recipients--an assessment of risk factors and natural history.
Non-adherence in pediatric liver transplant recipients--an assessment of risk factors and natural history.
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DOI：
10.1034/j.1399-3046.2000.00110.x
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发表时间：
2000-08-01
影响因子：
1.3
通讯作者：
Shneider, B L
中科院分区：
文献类型：
--
作者：
Lurie, S;Shemesh, E;Shneider, B L
尽管不坚持药物治疗是儿童肝移植受者晚期发病和死亡的主要原因之一，但人们对这种行为所涉及的危险因素知之甚少。报告了三起致命的不遵守规定的案例。通过对年龄匹配的 15 名儿科肝移植受者队列中的 27 个变量进行回顾性图表审查，研究了与不依从性相关的因素。严重不依从群体和年龄匹配群体之间最显着的差异包括药物滥用史、虐待儿童（身体或性）、家里没有两个父母、接受过公共援助、被诊断患有精神疾病以及辍学史。此外，移植前诊断为自身免疫性肝炎似乎与不依从性相关的更严重的医疗后遗症有关。由于本研究的回顾性设计，这些发现是初步的，但可以作为对这一重要现象进行前瞻性研究的起点。
Despite the fact that non-adherence to medical therapy is one of the major causes of late morbidity and mortality in pediatric liver transplant recipients, little is known of the risk factors involved in this behavior. Three cases of fatal non-adherence are reported. Factors associated with non-adherence were investigated by performing a retrospective chart review of a panel of 27 variables in an age-matched cohort of 15 pediatric liver transplant recipients. The most striking differences between the severely non-adherent group and the age-matched cohort included history of substance abuse, child abuse (physical or sexual), not having two parents at home, having received public assistance, having been diagnosed with a psychiatric disorder, and history of school dropout. In addition it appeared that a pretransplant diagnosis of autoimmune hepatitis was associated with more significant medical sequelae related to non-adherence. These findings are preliminary owing to the retrospective design of this study, but could be used as a starting point for a prospective study of this important phenomenon.