Institute of Liver Studies, King's College Hospital, London, UK.
Division of Paediatric Gastroenterology, Emory University School of Medicine, Atlanta, USA.
J Hepatol. 2017 Mar;66(3):631-644. doi: 10.1016/j.jhep.2016.11.013. Epub 2016 Nov 30.
An increasing number of patients with childhood liver disease survive into adulthood. These young adults are now entering adult services and require ongoing management. Aetiologies can be divided into liver diseases that develop in young adults which present to adult hepatologists i.e., biliary atresia and Alagille syndrome or liver diseases that occur in children/adolescents and adults i.e., autoimmune hepatitis or Wilson's disease. To successfully manage these young adults, a dynamic and responsive transition service is essential. In this review, we aim to describe the successful components of a transition service highlighting the importance of self-management support and a multi-disciplinary approach. We will also review some of the liver specific aetiologies which are unique to young adults, offering an update on pathogenesis, management and outcomes.
越来越多的儿童期肝病患者存活至成年期。这些年轻人现在进入了成人服务领域,需要持续管理。病因可分为在年轻成人中发展并向成人肝病专家就诊的肝病,例如胆道闭锁和 Alagille 综合征,或在儿童/青少年和成人中发生的肝病,例如自身免疫性肝炎或威尔逊病。为了成功管理这些年轻人,动态且响应迅速的过渡服务是必不可少的。在这篇综述中,我们旨在描述过渡服务的成功组成部分,强调自我管理支持和多学科方法的重要性。我们还将回顾一些特定于年轻人的肝脏病因,提供发病机制、管理和结局的最新信息。