Campagna Bianca R, Annunziato Rachel A
Department of Psychology, Fordham University, Bronx, New York, USA.
Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Pediatr Transplant. 2023 Jun;27(4):e14497. doi: 10.1111/petr.14497. Epub 2023 Mar 9.
Understanding the role of substance use is important in the equitable allocation of solid organs and may present an opportunity for improving outcomes among substance users who receive transplants. This scoping review presents findings related to substance use among pediatric and young adult transplant populations and suggests future directions.
A scoping review was conducted seeking studies related to substance use in pediatric and young adult transplant populations under the age of 39 years. Studies were deemed eligible if they collected data or addressed policy concerns and participants' mean age was below 39 years.
Twenty-nine studies were identified as eligible for this review. Overall, policies around substance use are largely inconsistent throughout both pediatric and adult transplant centers. Findings indicated that substance use among pediatric and young adult transplant recipients is similar to or lower than healthy peers. Few studies addressed marijuana use and opioid misuse, among other substances.
There is a general dearth of research on substance use in this population. The current findings suggest that substance use, although relatively less common, affects eligibility for transplant, may lead to poor outcomes, and affects medication adherence. Inconsistent substance use policies in transplant centers have the potential to result in bias. However, more research is needed on the effects of substance use among pediatric and young adult transplant candidates and recipients as well as on equitable policies for organ allocation for individuals who use substances.
了解物质使用情况对于实体器官的公平分配至关重要,并且可能为改善接受移植的物质使用者的治疗结果提供契机。本范围综述介绍了与儿科和年轻成人移植人群中的物质使用相关的研究结果,并提出了未来的研究方向。
进行了一项范围综述,以寻找与39岁以下儿科和年轻成人移植人群中的物质使用相关的研究。如果研究收集了数据或涉及政策问题且参与者的平均年龄低于39岁,则该研究被视为合格。
确定了29项研究符合本综述的要求。总体而言,儿科和成人移植中心关于物质使用的政策在很大程度上不一致。研究结果表明,儿科和年轻成人移植受者中的物质使用情况与健康同龄人相似或更低。很少有研究涉及大麻使用和阿片类药物滥用等其他物质。
该人群中关于物质使用的研究普遍匮乏。目前的研究结果表明,物质使用虽然相对不常见,但会影响移植资格,可能导致不良后果,并影响药物依从性。移植中心物质使用政策的不一致有可能导致偏见。然而,需要更多关于儿科和年轻成人移植候选者和受者中物质使用的影响以及关于物质使用者器官分配公平政策的研究。