Department of Psychiatry, Child and Adolescent Division, University of Colorado Denver, Aurora, Colorado.
Department of Pediatrics, University of Colorado Denver, Aurora, Colorado.
Pediatr Transplant. 2020 Jun;24(4):e13668. doi: 10.1111/petr.13668. Epub 2020 Feb 11.
Substance use is prevalent among youth and often leads to impairment in multiple domains. Additionally, substance use may pose adverse health issues post-transplant. Yet, practices related to substance use among pediatric patients who require organ transplant remain inconsistent. In this study, providers were surveyed for their perspectives on substance use among solid organ transplant candidates within a pediatric hospital.
An online survey was administered to providers on the heart, kidney, and liver transplant teams at one tertiary pediatric care center located in the intermountain region of the United States (N = 50, 42% response rate). Providers answered questions about the need for a hospital-wide policy across heart, liver, and kidney transplant teams within this transplant center, timing of substance use evaluation, types of substances eliciting concerns based on organ, and recommended interventions. Data were analyzed using descriptive statistics.
Providers felt strongly about the need for a policy to guide recommendations for substance use among transplant candidates. Providers wanted a hospital-wide substance use policy (84%) and a standardized measure for assessing substance use (98%). Respondents (98%) indicated that substance use should be assessed during the pretransplant evaluation. Respondents expressed varied concerns based on substance and organ type, and recommended interventions for patients to cease substance use prior to transplant listing.
This study highlights the need for a clear, directive, hospital-wide policy and standardized procedure for evaluating substance use among adolescent solid organ transplant candidates nationally across pediatric transplant centers.
物质使用在青少年中很普遍，通常会导致多个领域的功能障碍。此外，物质使用可能会在移植后带来不良的健康问题。然而，在需要进行器官移植的儿科患者中，与物质使用相关的实践仍然不一致。在这项研究中，调查了提供者对在一家儿科医院的实体器官移植候选者中物质使用的看法。
在美国山间地区的一家三级儿科护理中心，向心脏、肾脏和肝脏移植团队的提供者进行了在线调查（N=50，42%的回复率）。提供者回答了关于在该移植中心的心脏、肝脏和肾脏移植团队中需要制定全院范围的政策、物质使用评估的时间、根据器官类型引起关注的物质类型以及推荐干预措施的问题。使用描述性统计数据进行数据分析。
提供者强烈认为需要制定政策来指导移植候选者物质使用的建议。提供者希望有一个全院范围的物质使用政策（84%）和一个用于评估物质使用的标准化措施（98%）。受访者（98%）表示，应在移植前评估期间评估物质使用情况。受访者根据物质和器官类型表达了不同的担忧，并建议患者在移植名单之前停止物质使用。
这项研究强调了在全国范围内的儿科移植中心中，需要制定明确、有针对性、全院范围的政策和标准化程序，以评估青少年实体器官移植候选者的物质使用情况。
