LaRosa Christopher, Baluarte H Jorge, Meyers Kevin E C
Division of Nephrology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA.
Pediatr Transplant. 2011 Mar;15(2):128-41. doi: 10.1111/j.1399-3046.2010.01434.x.
LaR Pediatric solid-organ transplantation is an increasingly successful treatment for organ failure. Five- and 10-yr patient survival rates have dramatically improved over the last couple of decades, and currently, over 80% of pediatric patients survive into adolescence and young adulthood. Waiting list mortality has been a concern for liver, heart, and intestinal transplantation, illustrating the importance of transplant as a life-saving therapy. Unfortunately, the success of pediatric transplantation comes at the cost of long-term or late complications that arise as a result of allograft rejection or injury, immunosuppression-related morbidity, or both. As transplant recipients enter adolescence treatment, non-adherence becomes a significant issue, and the medical and psychosocial impacts transition to adulthood not only with regard to healthcare but also in terms of functional outcomes, economic potential, and overall QoL. This review addresses the clinical and psychosocial challenges encountered by pediatric transplant recipients in the current era. A better understanding of pediatric transplant outcomes and adult morbidity and mortality requires further ongoing assessment.
小儿实体器官移植是治疗器官衰竭日益成功的方法。在过去几十年中,5年和10年患者生存率显著提高,目前,超过80%的小儿患者存活至青春期和青年期。等待名单上的死亡率一直是肝、心和肠移植所关注的问题,这说明了移植作为一种挽救生命疗法的重要性。不幸的是,小儿移植的成功是以长期或晚期并发症为代价的,这些并发症是由同种异体移植排斥或损伤、免疫抑制相关的发病率或两者共同引起的。随着移植受者进入青春期治疗,不依从成为一个重要问题,并且医疗和心理社会影响不仅在医疗保健方面,而且在功能结局、经济潜力和总体生活质量方面都向成年期过渡。本综述探讨了当代小儿移植受者所面临的临床和心理社会挑战。更好地了解小儿移植结局以及成人发病率和死亡率需要进一步持续评估。