UK guideline on the transition and management of childhood liver diseases in adulthood
UK guideline on the transition and management of childhood liver diseases in adulthood
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DOI：
10.1111/apt.17904
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发表时间：
2024-02-22
影响因子：
7.6
通讯作者：
Samyn，Marianne
中科院分区：
文献类型：
--
作者：
Joshi，Deepak;Nayagam，Jeremy;Samyn，Marianne
儿童和青年期肝病的改善结果导致越来越多的年轻人（YA）进入成人肝脏服务。因此，成人肝病专家需要一个工作知识的疾病，几乎完全出现在儿童及其并发症adult.AimsTo提供成人肝病专家在YA过渡期护理方面的简明指南相关的关键疾病病因在临床practice.MethodsA系统的文献检索进行了使用Pubmed，Medline，Web的知识和科克伦数据库从1980年至2023年。使用与肝病（“胆汁淤积性肝病”、“胆道闭锁”、“代谢”、“儿科肝病”、“自身免疫性肝病"）、向成人护理过渡（”过渡服务“、”年轻成人服务“）和青少年护理相关的MeSH检索词。证据的质量和分级的建议进行了评估，使用分级的建议评估，发展和评价（GRADE）system.ResultsThese指南处理的过渡，YA和地址的关键病因的成人肝病学家在以下标题：（1）模式和提供的护理;（2）筛选和管理的精神健康障碍;（3）病因;（4）治疗的方法;（5）治疗的方法。（4）肝移植的时机和作用;和（5）性健康和fertilization.ConclusionsThese是第一个国家制定的指导方针的过渡和管理的儿童肝脏疾病在成年期。他们提供了一个基础临床护理的框架，我们设想这将改善患有慢性肝病的YA的结局。
IntroductionImproved outcomes of liver disease in childhood and young adulthood have resulted in an increasing number of young adults (YA) entering adult liver services. The adult hepatologist therefore requires a working knowledge in diseases that arise almost exclusively in children and their complications in adulthood.AimsTo provide adult hepatologists with succinct guidelines on aspects of transitional care in YA relevant to key disease aetiologies encountered in clinical practice.MethodsA systematic literature search was undertaken using the Pubmed, Medline, Web of Knowledge and Cochrane database from 1980 to 2023. MeSH search terms relating to liver diseases (‘cholestatic liver diseases’, ‘biliary atresia’, ‘metabolic’, ‘paediatric liver diseases’, ‘autoimmune liver diseases’), transition to adult care (‘transition services’, ‘young adult services’) and adolescent care were used. The quality of evidence and the grading of recommendations were appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.ResultsThese guidelines deal with the transition of YA and address key aetiologies for the adult hepatologist under the following headings: (1) Models and provision of care; (2) screening and management of mental health disorders; (3) aetiologies; (4) timing and role of liver transplantation; and (5) sexual health and fertility.ConclusionsThese are the first nationally developed guidelines on the transition and management of childhood liver diseases in adulthood. They provide a framework upon which to base clinical care, which we envisage will lead to improved outcomes for YA with chronic liver disease.