Transition to adult care for pediatric liver transplant recipients: the Western Australian experience
Transition to adult care for pediatric liver transplant recipients: the Western Australian experience
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儿科肝移植受者向成人护理的过渡：西澳大利亚的经验
DOI：
10.1111/petr.12820
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发表时间：
2017
影响因子：
1.3
通讯作者：
G. Jeffrey
中科院分区：
文献类型：
--
作者：
Tim Mitchell;H. Gooding;C. Mews;L. Adams;G. MacQuillan;G. Garas;M. Ravikumara;A. López;M. Collins;G. Jeffrey
过渡到成人护理是儿科移植受者的脆弱时期，与药物依从性降低、移植物丢失和死亡率增加有关。儿童移植受者和健康同龄人之间的年轻人心理社会结果不同。我们对通过我们中心过渡的所有儿科肝移植受者进行了一项单中心、回顾性队列研究。本研究旨在评估澳大利亚一家中心的过渡期儿科肝移植受者的结局，包括死亡率、依从性和心理社会发病率。过渡后的1年和5年生存率分别为100%和92%。没有晚期排斥反应。总体而言，66.7%的患者依从免疫抑制治疗，61.1%的患者依从门诊就诊。服药依从性和门诊出勤率之间存在显著关系，以及存在心理问题与门诊不出勤之间存在显著关系。心理社会结果与一般人群的年龄匹配数据一致。所有患者均在过渡期后就业或学习。这是第一次在澳大利亚人群中进行此类研究，结果上级已发表的国际数据。尽管已经证明了良好的结果，但过渡计划可能会改善该队列的医疗保健参与度。
Transition to adult care is a vulnerable period for pediatric transplant recipients and is associated with reduced medication compliance, graft loss, and increased mortality. Psychosocial outcomes in young adults differ between pediatric transplant recipients and their healthy peers. We conducted a single‐center, retrospective cohort study of all pediatric liver transplant recipients who were transitioned through our center. This study aimed to assess the outcomes of transitioned pediatric liver transplant recipients at an Australian center, including mortality, adherence, and psychosocial morbidity. The 1‐ and 5‐year survival rates following transition were 100% and 92%, respectively. There were no episodes of late rejection. In total, 66.7% of patients were compliant with immunosuppression and 61.1% of patients were compliant with clinic attendance. There was a significant relationship between medication compliance and clinic attendance, as well as presence of psychological issues with clinic non‐attendance. Psychosocial outcomes were in keeping with age‐matched data from the general population. All patients were employed or studying following transition. This is the first study of its kind in the Australian population, and outcomes were superior to published international data. Despite the demonstrated good outcomes, transition programs may improve healthcare engagement in this cohort.