Jara Paloma, Hierro Loreto
Servicio de Hepatología y Trasplante, Hospital Infantil Universitario La Paz, Madrid, España.
Gastroenterol Hepatol. 2010 May;33(5):398-410. doi: 10.1016/j.gastrohep.2009.11.004. Epub 2010 Jan 31.
Liver transplantation allows long-term survival (10 years or more) in 75% of children receiving transplants before 2000. The risk of mortality after the first year is 4-10% in the next 10-20 years. Chronic rejection affects 6%. The need for late retransplantation is 3-5%. However, the follow-up of these patients involves the management of diverse problems in the graft (immunological, biliary, vascular) and others related to the use of immunosuppressants (renal dysfunction, lymphoproliferative syndrome). The transition from pediatric to adult care generates special needs. Adolescence and young adulthood are associated with a lack of compliance. Adult specialists should be aware of the special features of the original diagnosis and the surgical techniques used in childhood transplantation. Final quality of life is good overall but is lower than that in healthy young persons.
肝移植可使2000年前接受移植的75%儿童长期存活（10年或更长时间）。第一年之后，在接下来的10至20年里，死亡风险为4%至10%。慢性排斥反应发生率为6%。晚期再次移植的需求为3%至5%。然而，对这些患者的随访涉及移植物中各种问题（免疫、胆道、血管）的管理以及与免疫抑制剂使用相关的其他问题（肾功能障碍、淋巴增殖综合征）。从儿科护理向成人护理的过渡产生了特殊需求。青春期和青年期与依从性差有关。成人专科医生应了解最初诊断的特殊特征以及儿童移植中使用的手术技术。总体而言，最终生活质量良好，但低于健康年轻人。
