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优化小儿肾移植受者长期预后的多学科方法:多方面需求、风险评估策略及潜在干预措施。

Multidisciplinary approach to optimizing long-term outcomes in pediatric kidney transplant recipients: multifaceted needs, risk assessment strategies, and potential interventions.

作者信息

Gu Lidan, Gross Amy C, Kizilbash Sarah

机构信息

Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.

Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota Medical School, 2450 Riverside Ave, MB680, Minneapolis, MN, 55454, USA.

出版信息

Pediatr Nephrol. 2025 Mar;40(3):661-673. doi: 10.1007/s00467-024-06519-x. Epub 2024 Oct 2.

Abstract

The post-transplant course of pediatric kidney transplant recipients is marked by a myriad of challenges, encompassing medical complications, recurrent hospitalizations, physical and dietary restrictions, and mental health concerns such as depression, anxiety, and post-traumatic stress disorder. Moreover, pediatric recipients are at risk of neurodevelopmental impairment, which may result in neurocognitive deficits and pose significant psychosocial obstacles. Addressing these multifaceted demands necessitates a multidisciplinary approach to pediatric kidney transplant care. However, the existing literature on the effective implementation of such a model remains scarce. This review examines the psychosocial and neurodevelopmental challenges faced by pediatric kidney transplant recipients and their families, discussing their impact on long-term transplant outcomes. Furthermore, it provides insights into risk assessment strategies and potential interventions within a multidisciplinary framework, aiming to enhance patient care and optimize post-transplant outcomes.

摘要

小儿肾移植受者移植后的病程面临着众多挑战,包括医疗并发症、反复住院、身体和饮食限制,以及心理健康问题,如抑郁、焦虑和创伤后应激障碍。此外,小儿受者有神经发育受损的风险,这可能导致神经认知缺陷并带来重大的社会心理障碍。应对这些多方面的需求需要采取多学科方法来进行小儿肾移植护理。然而,关于有效实施这种模式的现有文献仍然匮乏。本综述探讨了小儿肾移植受者及其家庭面临的社会心理和神经发育挑战,讨论了它们对长期移植结果的影响。此外,它还提供了多学科框架内风险评估策略和潜在干预措施的见解,旨在加强患者护理并优化移植后结果。

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