Oral Health Outcomes in Pediatric Transplant Recipients

描述（由申请人提供）：我们建议开展一项研究，探索 UCSF 儿童肾移植受者 (RTR) 和肝移植受者 (LTR) 人群中与新一代免疫抑制剂相关的特定口腔健康结果。感兴趣的口腔健康结果包括粘膜疾病（例如念珠菌病、毛状白斑、溃疡、疣、唇癌、非霍奇金淋巴瘤和卡波西肉瘤 (KS)、牙龈肿大 (GE) 和牙科需求。拟议研究的主要研究者是 K23 奖的获得者，该奖的中心主题是成人 RTR 的口腔健康结果研究。 Shiboski 还获得了少量试点资金，用于研究患有医疗问题的儿童对牙科护理的利用情况，作为该试点项目的一部分，她一直在招募儿童 RTR 和 LTR，并对其进行口腔健康调查问卷。 利用这一不断发展的研究基础设施，本申请的目标是申请资金对儿科 RTR 和 LTR 进行前瞻性研究，通过在 2 年内每 6 个月的时间间隔跟踪这些儿童来探索特定的口腔健康结果。 儿科 RTR 和 LTR 拟议研究的具体目标是： a. 评估与新的免疫抑制药物治疗方案、移植类型以及移植手术后时间相关的口腔粘膜疾病和 GE 的患病率和发病率； b. 估计与社会人口变量和移植手术后时间相关的未满足牙科需求的发生率； c. 收集未满足的牙科需求（例如晚期龋齿、与 GE 相关的慢性牙龈炎症）与急性移植排斥反应史之间任何潜在关联的初步数据。

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).