Gastroenterology-Hepatology-Nutrition Unit, Hôpital Necker-Enfants Malades, Paris, France.
Department of Pediatrics, Department of Woman and Child Health and Public Health, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
Pediatr Transplant. 2021 May;25(3):e13982. doi: 10.1111/petr.13982. Epub 2021 Feb 16.
Health-related quality of life (HRQOL) after intestinal transplantation (IT) is important, as many psychological troubles have been reported in these patients on the long term. Our aim was to assess and compare HRQOL of patients after IT to patients after liver transplantation (LT) or on home parenteral nutrition (HPN) for intestinal failure. A cross-sectional study included patients and their parents between 10 and 18 years of age, on HPN for more than 2 years, or who underwent IT or LT, with a graft survival longer than 2 years. Quality of life was explored by Child Health Questionnaire. Thirteen children-parents dyads after IT, 10 after LT, and eight children on HPN completed the survey. Patients were a median age of 14 years old, a median of 10 years post-transplantation or on HPN. Patients after IT scored lower than patients after LT or on HPN in "social limitations due to behavioral difficulties" and in "behavior." They scored higher than those on HPN in "global health." Parents of children after IT scored lower than those after LT in many domains. No relevant correlation with clinical data was found. Our study showed the multi-level impact of IT on quality of life of patients and their parents. It highlights the importance of a regular psychological follow-up for patients, but also of a psychological support for families. Helping the patients to overcome the difficulties at adolescence may improve their mental health in adulthood.
肠移植(IT)后的健康相关生活质量(HRQOL)很重要,因为长期以来,这些患者报告了许多心理困扰。我们的目的是评估和比较 IT 后患者与肝移植(LT)后或因肠衰竭而接受家庭肠外营养(HPN)的患者的 HRQOL。一项横断面研究纳入了年龄在 10 至 18 岁之间、接受 HPN 治疗超过 2 年或接受 IT 或 LT 治疗且移植物存活时间超过 2 年的患者及其父母。通过儿童健康问卷(Child Health Questionnaire)来评估生活质量。13 对 IT 后患儿-父母、10 对 LT 后患儿-父母和 8 对 HPN 患儿-父母完成了调查。患者的中位年龄为 14 岁,移植后或接受 HPN 治疗的中位时间为 10 年。与 LT 后或 HPN 患儿相比,IT 后患儿在“因行为问题导致的社交受限”和“行为”方面的得分较低,而在“总体健康”方面的得分较高。IT 后患儿的父母在许多方面的评分均低于 LT 后患儿的父母。未发现与临床数据相关的相关性。我们的研究表明 IT 对患者及其父母生活质量的多层面影响。它强调了定期对患者进行心理随访的重要性,也强调了对家庭提供心理支持的重要性。帮助患者克服青春期的困难可能会改善他们成年后的心理健康。