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移植受者的青少年和青年期发育。

Adolescent and Young Adult Development in Transplant Recipients.

机构信息

Department of Pediatrics, Division of Adolescent and Young Adult Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

出版信息

Pediatr Transplant. 2024 Nov;28(7):e14866. doi: 10.1111/petr.14866.

Abstract

Solid organ transplantation (SOT) is the gold standard of therapy for individuals with end-organ dysfunction. Improved survival outcomes after SOT can help adolescent and young adult (AYA) recipients lead long and healthy life. However, successful SOT during adolescence and young adulthood is often complicated by the innate developmental challenges of this age group. The psychosocial tasks of adolescence include identity development, autonomous decision-making, establishing social networks, educational and vocational preparation, and navigating romantic relationships. These goals may be amplified or delayed for pediatric SOT recipients. Adolescence is also marked by rapid physical changes in linear growth and the development of secondary sexual characteristics. Yet AYA may experience physical and pubertal delays related to transplantation, as well as exaggerated body image dissatisfaction due to medication side effects. Strict adherence to medication and post-transplant regimens may interfere with adolescents' desire for normalcy and fitting in with peers. Healthcare providers should be aware that AYA value education and self-empowerment in transplant care. Transplant success needs to be defined by both medical and psychosocial outcomes, particularly when it relates to the vulnerable AYA population. Fortunately, investment from the patient, family, and care team can aid in transplant recovery and success. This article will identify the developmental challenges faced by AYA undergoing solid organ transplantation as well as strategies to engage positive outcomes.

摘要

实体器官移植(SOT)是治疗终末期器官功能障碍患者的金标准。SOT 后生存结果的改善可以帮助青少年和年轻成人(AYA)受者过上长久而健康的生活。然而,青少年和年轻成人时期的成功 SOT 常常因该年龄段固有的发育挑战而变得复杂。青少年的心理社会任务包括身份发展、自主决策、建立社交网络、接受教育和职业准备以及处理恋爱关系。这些目标对于儿科 SOT 受者来说可能会被放大或延迟。青春期还伴随着线性生长和第二性征发育的快速身体变化。然而,AYA 可能会经历与移植相关的身体和青春期延迟,以及由于药物副作用而导致的夸大的身体形象不满。严格遵守药物和移植后方案可能会干扰青少年对正常生活和与同龄人相处的渴望。医疗保健提供者应该意识到,AYA 重视在移植护理中获得教育和自我赋权。移植成功需要通过医疗和心理社会结果来定义,特别是当涉及到脆弱的 AYA 人群时。幸运的是,患者、家庭和护理团队的投入可以帮助移植康复和成功。本文将确定接受实体器官移植的 AYA 所面临的发育挑战,并提出实现积极结果的策略。

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