Department of Child Health, University of Missouri School of Medicine, 400 N. Keene St, 65201, Columbia, MO, USA.
Center for Gut Rehabilitation and Transplantation, Department of General Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave, 44195, Cleveland, OH, USA.
Curr Gastroenterol Rep. 2022 Nov;24(11):145-155. doi: 10.1007/s11894-022-00848-3. Epub 2022 Aug 30.
Intestinal failure and transplantation may significantly impact physical, neurocognitive, and psychosocial development in pediatric patients. Currently, there is a paucity of literature on the effects of intestinal failure and transplantation on these aspects of development. This article will review the current literature and discuss the short and long-term impacts as well as interventions to improve clinical outcomes in children with intestinal failure or those undergoing transplantation.
Psychological disorders, neurodevelopmental delay, and social maladaptation are frequently encountered in this patient population. While the main focus is often on medical management, equal emphasis should be placed on other aspects of development such as increasing social support and improving school performance. The transition to adulthood also presents many obstacles for patients and healthcare providers should anticipate challenges such as childbirth, employment, and raising a family. The pre-operative, perioperative, and post-operative periods all represent opportunities for medical intervention. Frequent monitoring of physical, psychosocial, and neurocognitive status helps to improve clinical outcomes and long-term quality of life. Future research should emphasize continued development of multidisciplinary programs and specialized services to help address the physical and psychosocial needs of children with intestinal failure as well as transplant recipients.
肠衰竭和移植可能会对儿科患者的身体、神经认知和心理社会发育产生重大影响。目前，关于肠衰竭和移植对这些发育方面的影响的文献很少。本文将回顾现有文献，并讨论肠衰竭或接受移植的儿童的短期和长期影响，以及改善临床结局的干预措施。
该患者群体中经常出现心理障碍、神经发育迟缓以及社会适应不良。虽然主要重点通常是医疗管理，但应同样重视其他发育方面，例如增加社会支持和提高学业成绩。向成年期过渡也给患者和医疗保健提供者带来了许多障碍，他们应该预测到诸如分娩、就业和养家等挑战。术前、围手术期和术后期间都代表着医疗干预的机会。频繁监测身体、心理社会和神经认知状况有助于改善临床结局和长期生活质量。未来的研究应强调继续发展多学科计划和专门服务，以帮助满足肠衰竭儿童以及移植受者的身体和心理社会需求。
