Division of Pediatric Kidney Diseases, Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois, USA.
Pediatr Transplant. 2021 Feb;25(1):e13791. doi: 10.1111/petr.13791. Epub 2020 Jul 28.
Pediatric recipients of life-saving organ transplants are living longer, with improved graft and overall survivals. After successful transplant, children are encouraged to return to "normal life," with school attendance and participation in age-appropriate physical activities. This transition may cause stress to the recipients, parents, teachers, and other participating caregivers and staff. Planning for school reentry and assuring education for and open lines of communication with the school staff can help alleviate some of this discomfort and ease the process for the patient and the family. Cardiovascular disease has emerged as the leading cause of death in survivors of pediatric transplantation and is contributed to by modifiable risk factors such as obesity, hypertension, and the MS. Physical activity is a proven tool in decreasing surrogate markers of this risk. Sports participation is an important way to promote an enjoyment of physical activity that can ideally persist into adulthood, but conflicting advice and opinions exist regarding type and participation in physical activity. Moreover, specific recommendations are likely not applicable to all recipients, as certain degrees of rehabilitation may be needed depending on degree and length of illness. In general, a program of rehabilitation and increased physical activity has been shown to be safe and effective for most pediatric transplant recipients. Focusing on optimizing the "normal" childhood activities of going to school and participating in sports can improve the physical, social, cognitive, and mental health outcomes of this population after transplant and should be prioritized.
儿科接受者的生命挽救器官移植的寿命更长，移植物和整体存活率都有所提高。成功移植后，鼓励儿童重返“正常生活”，包括上学和参加适合年龄的体育活动。这种过渡可能会给接受者、家长、教师和其他参与的照顾者和工作人员带来压力。计划重新入学并确保教育，并与学校工作人员保持开放的沟通渠道，可以帮助减轻一些不适，并为患者和家庭简化这个过程。心血管疾病已成为儿科移植幸存者的主要死亡原因，其可归因于肥胖、高血压和代谢综合征等可改变的危险因素。身体活动是降低这些风险替代指标的有效方法。运动参与是促进身体活动享受的重要途径，理想情况下可以持续到成年期，但关于身体活动的类型和参与，存在相互矛盾的建议和意见。此外，由于康复程度和持续时间的不同，特定的建议可能不适用于所有接受者。一般来说，康复和增加身体活动的计划已被证明对大多数儿科移植接受者是安全有效的。专注于优化“正常”的儿童活动，如上学和参加运动，可以改善这一人群在移植后的身体、社交、认知和心理健康状况，应优先考虑。
