de Oliveira Janete Teresinha Pires, Kieling Carlos Oscar, da Silva Anaís Back, Stefani Joel, Witkowski Maria Carolina, Smidt Camila Ribas, Mariano da Rocha Carolina R, Hirakata Vania Naomi, Grossini Maria da Graça, Zanotelli Maria Lúcia, Gonçalves Vieira Sandra Maria
Postgraduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Pediatric Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Pediatr Transplant. 2017 Dec;21(8). doi: 10.1111/petr.13058. Epub 2017 Oct 15.
MLVI has been used to assess adherence. To determine the MLVI in children <12 years of age at transplantation and to identify demographic correlates and consequences for the graft. This is a retrospective study of 50 outpatients (4.0 ± 3.5 years), at least 13-month post-liver transplantation. The outcomes evaluated were MLVI, ALT > 60 IU/L, ACR, death, and graft loss. We analyzed demographic and socioeconomic characteristics, indication for transplantation, and type of donor. Student's t test and the chi-square test were used. Statistical significance was set at P ≤ .05. Seventy-two percent were infants or preschoolers, 62% biliary atresia. Seventy-four percent of the mothers had middle-school education, and 54% of the families had an income ≤3632.4 US$/y. Twenty-two (44%) patients had a MLVI ≥ 2 SD; this was more prevalent in families with higher incomes (P = .045). ALT levels > 60 IU/L were more common in MLVI ≥ 2 SD group (P = .035). ACR episodes were similar between groups (P = 1.000). No patient died or lost the graft. MLVI ≥ 2 SD may be an indicator of the risk of medication non-adherence.
MLVI已被用于评估依从性。目的是确定移植时年龄小于12岁儿童的MLVI，并确定其人口统计学相关性以及对移植物的影响。这是一项对50例肝移植术后至少13个月的门诊患者（年龄4.0±3.5岁）进行的回顾性研究。评估的结果包括MLVI、ALT>60 IU/L、急性细胞排斥反应（ACR）、死亡和移植物丢失。我们分析了人口统计学和社会经济特征、移植指征和供体类型。采用学生t检验和卡方检验。设定统计学显著性为P≤0.05。72%为婴儿或学龄前儿童，62%为胆道闭锁。74%的母亲具有中学教育程度，54%的家庭年收入≤3632.4美元。22例（44%）患者的MLVI≥2个标准差；这在高收入家庭中更为普遍（P=0.045）。ALT水平>60 IU/L在MLVI≥2个标准差组中更为常见（P=0.035）。两组间ACR发作情况相似（P=1.000）。没有患者死亡或失去移植物。MLVI≥2个标准差可能是药物治疗不依从风险的一个指标。
