Oral Health Outcomes in Pediatric Transplant Recipients

描述（由申请人提供）：我们提议开展一项研究，探索新一代免疫抑制剂在UCSF儿童肾移植受者（RTRs）和肝移植受者（LTRs）群体中的特定口腔健康结果。口腔健康结局包括粘膜疾病（如念珠菌病、毛状白斑、溃疡、疣、唇部癌、非霍奇金淋巴瘤和卡波西肉瘤（KS））、牙龈增大（GE）和牙科需求。拟议研究的首席研究员是K23奖的获得者，该奖的中心主题是成人rtr患者口腔健康结果的研究。Shiboski博士还获得了少量试点资金，用于研究医疗受损儿童对牙科护理的利用情况。作为这个试点项目的一部分，她一直在为UCSF的儿科rtr和ltr招募和管理口腔健康问卷。

DESCRIPTION (provided by applicant): We propose to conduct a study to explore specific oral health outcomes in relation to new generation immunosuppressants in a population of pediatric renal transplant recipients (RTRs) and liver transplant recipients (LTRs) at UCSF. Oral health outcomes of interest include mucosal diseases (e.g., candidiasis, hairy leukoplakia, ulcers, warts, lip carcinoma, non-Hodgkin's lymphoma, and Kaposi's sarcoma (KS), gingival enlargement (GE), and dental needs. The principal investigator of the proposed study is a recipient of a K23 award that bears as its central theme the study of oral health outcomes among adult RTRs. Dr. Shiboski also received a small amount of pilot funds to study utilization of dental care among medically compromised children. As part of this pilot project she has been recruiting, and administering oral health questionnaires to pediatric RTRs and LTRs at UCSF. Taking advantage of this developing research infrastructure, the goal of the present application is to request funds to conduct a prospective study among pediatric RTRs and LTRs, exploring specific oral health outcomes by following these children at 6-months intervals over a 2-year period. The Specific Aims of the proposed study among pediatric RTRs and LTRs are: a. To estimate the prevalence and incidence of oral mucosal diseases and GE in relation to new immunosuppressive drug regimens, type of transplant, and time since transplant surgery; b. To estimate the prevalence of unmet dental need in relation to socio-demographic variables and time since transplant surgery; c. To collect preliminary data on any potential association between unmet dental needs (e.g., advanced caries, chronic gingival inflammation associated with GE) and history of acute graft rejection episode(s).