Özbaran Burcu, Çek Didem, Doğan Nurhak, Ay Oğuzhan, Tutar Zülal Ülger, Özbaran Mustafa
Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ege University, Izmir, Türkiye.
Department of Pediatric Cardiology, Faculty of Medicine, Ege University, Izmir, Türkiye.
Noro Psikiyatr Ars. 2024 Nov 28;61(4):377-379. doi: 10.29399/npa.28647. eCollection 2024.
Organ transplantation practices have witnessed tremendous advances all over the world and in Türkiye in recent years, and the pre-transplantation preparation, operation and postoperative follow-up procedures are being meticulously handled. However, there is very limited information about follow-up processes of pediatric patients with autism spectrum disorder (ASD) undergoing organ transplantation. Furthermore, it is difficult to manage the arduous and long-term care and follow-up processes in ASD cases undergoing organ transplantation. In this case report, an 11-year-old male patient with a diagnosis of ASD and attention deficit-hyperactivity disorder (ADHD) was reviewed psychiatrically for the suitability of ventricular assist device (VAD) implantation and heart transplantation, and the multidisciplinary council process was evaluated. The council decided that the case was suitable for heart transplantation but not suitable for long-term intracorporeal device implantation due to behaviors such as plucking wounds, playing with vascular access, and being nervous about vascular access. The council stated that due to sensory hypersensitivity of the case, implantation of such a device may further increase anxiety, and involuntary damage to the device may result in personal harm. We hope that this case report will guide future endeavors to develop devices suitable for cases with ASD or other behavioral problems.
近年来，器官移植实践在全球以及土耳其都取得了巨大进展，移植前准备、手术及术后随访程序都得到了精心处理。然而，关于自闭症谱系障碍（ASD）儿童患者器官移植后的随访过程，相关信息非常有限。此外，对接受器官移植的ASD病例进行艰巨且长期的护理和随访过程也颇具难度。在本病例报告中，对一名诊断为ASD和注意力缺陷多动障碍（ADHD）的11岁男性患者进行了精神科评估，以确定其是否适合植入心室辅助装置（VAD）和进行心脏移植，并对多学科委员会的流程进行了评估。委员会决定该病例适合进行心脏移植，但由于存在抓挠伤口、玩弄血管通路以及对血管通路感到紧张等行为，不适合长期植入体内装置。委员会指出，由于该病例存在感觉过敏，植入此类装置可能会进一步加重焦虑，且装置的意外损坏可能会导致人身伤害。我们希望本病例报告能为未来开发适合ASD或其他行为问题患者的装置提供指导。
