Follow-Up of Pediatric Liver Transplant Patients After Reaching Adulthood.
Follow-Up of Pediatric Liver Transplant Patients After Reaching Adulthood.
复制标题
儿童肝移植患者成年后的随访。
DOI：
10.12659/aot.899462
复制
发表时间：
2016
影响因子：
1.1
通讯作者：
M. Wawrzynowicz
中科院分区：
文献类型：
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作者：
Justyna Rajchert;Monika Rosa;J. Pawłowska;M. Parczewski;M. Wawrzynowicz
尽管移植结果良好，但在儿童肝脏受者的移植后管理中存在一个脆弱的时期，这是儿童成为青少年的时间。这段时间的心理困扰会影响依从性，并可能导致过早的移植失败和移植物丢失。我们对转移到我们成人服务的儿科肝移植受者进行了回顾性分析，以确定与过渡到成人护理相关的关键问题。材料与方法我们分析了从2000年至2015年12月从儿科移植后门诊转移到成人移植后服务的20名肝脏受者的医疗档案。对于生存分析，使用Kaplan-Meier模型和对数秩检验和考克斯比例风险回归模型计算风险比（HR）。结果研究人群的生存率超过90%。主要并发症是晚期急性排斥反应，在大多数情况下，由于不遵守。有一例复发性肝病和新发移植物疾病。结论：可能需要为年轻人提供专门的服务，以优化结果。
BACKGROUND Despite excellent transplantation results, there is a vulnerable period of time in the post-transplant management of pediatric liver recipients, which is the time when a child becomes an adolescent. This period of psychological distress influences compliance and may result in premature transplant failure and graft loss. We performed a retrospective review of pediatric liver transplant recipients, transferred to our service for adults, in order to identify key issues associated with transition into the adult care. MATERIAL AND METHODS We analyzed medical files of 20 liver recipients transferred from pediatric post-transplant outpatient clinic to the post-transplant service for adults, since year 2000 until December 2015. For survival analyses, Kaplan-Meier model with log-rank test and Cox proportional hazards regression model, to calculate hazard ratio (HR), were used. RESULTS Survival rate exceeds 90% in the study population. The major complication was late acute rejection, in most instances due to non-compliance. There were single cases of recurrent liver disease and de novo graft disorders. CONCLUSIONS Dedicated service for young people may be needed to optimize outcomes.