Dobbels Fabienne, Van Damme-Lombaert Rita, Vanhaecke Johan, De Geest Sabina
Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium.
Pediatr Transplant. 2005 Jun;9(3):381-90. doi: 10.1111/j.1399-3046.2005.00356.x.
One-year graft and patient survival are better in adolescent transplant recipients (age 11-19 years) than in younger (age < 11 years) pediatric transplant recipients. However, several groups found that long-term outcomes (> i.e. 5 year post-transplant) in the adolescent age group are significantly worse than in younger transplant recipients. A behavioral factor that could explain an important part of the poorer clinical outcome in adolescent transplant recipients is non-compliance with medication taking. Adolescents, like all organ transplant recipients irrespective of their age, must adhere to a life-long immunosuppressive regimen in addition to other aspects of their therapeutic regimen. Therefore, adolescent transplant recipients, as all transplant patients, should be regarded as a chronically ill patient population in whom behavioral and psychosocial management is equally important as state-of-the-art medical management. This paper provides an overview of the current knowledge on prevalence, clinical consequences, and risk-factors for non-compliance with the immunosuppressive regimen in adolescent transplant recipients and offers some suggestions for adolescent-tailored interventions to improve medication adherence.
青少年移植受者（11 - 19岁）的1年移植物和患者生存率优于年龄较小的儿科移植受者（年龄<11岁）。然而，多个研究小组发现，青少年年龄组的长期结局（即移植后5年以上）明显比年龄较小的移植受者差。一个可以解释青少年移植受者较差临床结局的重要部分的行为因素是不遵医嘱服药。青少年与所有器官移植受者一样，无论年龄大小，除了治疗方案的其他方面外，都必须坚持终身免疫抑制方案。因此，青少年移植受者与所有移植患者一样，应被视为慢性病患者群体，其中行为和心理社会管理与先进的医疗管理同样重要。本文概述了目前关于青少年移植受者不遵医嘱进行免疫抑制治疗方案的患病率、临床后果和风险因素的知识，并为针对青少年的干预措施提供了一些建议，以提高药物依从性。
