Treem W R, Etienne N L, Hyams J S
Gastroenterol Nurs. 1990 Summer;13(1):44-53. doi: 10.1097/00001610-199007000-00014.
Increasing numbers of children are receiving liver transplants at major centers and returning to their home hospitals for long-term follow-up. This review summarizes the long-term complications in pediatric liver transplant recipients and their recognition and management. Emphasis is placed on an understanding of the practical aspects of the pharmacokinetics and toxicity of cyclosporine, the major immunosuppressive drug used in these patients. Common infectious problems, particularly serious viral infections, are reviewed with their unique clinical presentations in this immunocompromised population. Therapeutic alternatives for episodes of acute rejection are offered to facilitate communication with the transplant center and familiarize the local pediatric gastroenterologist and his or her staff with the management issues facing those who take care of these complex patients.
越来越多的儿童在各大中心接受肝脏移植，并回到当地医院进行长期随访。这篇综述总结了儿童肝移植受者的长期并发症及其识别和处理方法。重点在于理解环孢素（这些患者使用的主要免疫抑制药物）的药代动力学和毒性的实际情况。对常见的感染问题，尤其是严重的病毒感染，结合其在这个免疫功能低下人群中的独特临床表现进行了综述。提供了急性排斥反应发作的治疗替代方案，以促进与移植中心的沟通，并让当地儿科胃肠病学家及其工作人员熟悉照顾这些复杂患者所面临的管理问题。
