Division of Nephrology, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA.
Pediatrics. 2011 Apr;127(4):742-53. doi: 10.1542/peds.2010-1232. Epub 2011 Mar 7.
Pediatric solid-organ transplantation is an increasingly successful treatment for solid-organ failure. With dramatic improvements in patient survival rates over the last several decades, there has been a corresponding emergence of complications attributable to pretransplant factors, transplantation itself, and the management of transplantation with effective immunosuppression. The predominant solid-organ transplantation sequelae are medical and psychosocial. These sequelae have a substantial effect on transition to adult care; as such, hurdles to successful transition of care arise from the patients, their families, and pediatric and adult health care providers. Crucial to successful transitioning is the ongoing development of a sense of autonomy and responsibility for one's own care. In this article we address the barriers to transitioning that occur with long-term survival in pediatric solid-organ transplantation. Although a particular transitioning model is not promoted, practical tools and strategies that contribute to successful transitioning of pediatric patients who have received a transplant are suggested.
儿科实体器官移植是治疗实体器官衰竭的一种越来越成功的方法。在过去几十年中，患者生存率显著提高，因此出现了与移植前因素、移植本身以及有效的免疫抑制治疗移植相关的并发症。主要的实体器官移植后遗症是医学和社会心理方面的。这些后遗症对向成人护理的过渡有重大影响；因此，成功过渡护理的障碍来自患者、他们的家庭以及儿科和成人医疗保健提供者。成功过渡的关键是不断发展对自己护理的自主权和责任感。在本文中，我们探讨了长期生存的儿科实体器官移植患者过渡中遇到的障碍。虽然没有特别推荐特定的过渡模式，但本文提出了有助于接受过移植的儿科患者成功过渡的实用工具和策略。
