Lefkowitz Debra S, Triplett Kelli, Schneider Lauren, West Kara, Anton Corinne, Rea Kelly E, Brosbe Micah, Christofferson Elizabeth S, Christon Lillian, Kasparian Nadine, Lamari-Fisher Alexandra, McIntyre Katie, Plevinsky Jill, Auerbach Scott, Bansal Neha, Benden Christian, Dugan Molly, Edelson Jonathan, Gross-Toalson Jami, Mayersohn Gillian, Prufe Jenny, White Rachel M, Wichart Jenny, Wray Jo, Cousino Melissa K
Children's Hospital of Philadelphia, Philadelphia, PA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Children's Medical Center; University of Texas Southwestern Medical Center, Dallas, TX.
J Heart Lung Transplant. 2025 Apr;44(4):487-502. doi: 10.1016/j.healun.2024.11.028.
The psychosocial evaluation plays an essential role in the multidisciplinary assessment of pediatric patients for thoracic organ transplantation or ventricular assist device (VAD) placement. However, there is considerable practice variation with regard to the content and process of the evaluation, with no known recent published guidelines. Furthermore, the pediatric evaluation necessarily differs from the adult evaluation in a number of substantive ways, including caregiver roles and decision-making. A writing committee of 25 multidisciplinary experts in pediatric cardiothoracic transplantation/VAD was established, who conducted a comprehensive literature review which resulted in the development of this consensus-based framework. This framework, which is a collaborative effort of the International Society for Heart and Lung Transplantation (ISHLT), the International Pediatric Transplant Association (IPTA), the Pediatric Heart Transplant Society (PHTS), the Advancing Cardiac Therapies Improving Outcomes Network (ACTION), and Transplant Families, represents the first known framework specific to both the content and process of the psychosocial evaluation for pediatric cardiothoracic transplantation/VAD. Attention was paid to relevant ethical, cultural and health equity considerations inherent in the pediatric evaluation process. Rather than provide a proscriptive evaluation process, the goal was to create a flexible framework to encourage consistency across centers, while also acknowledging the complexities inherent in evaluating children and their families for cardiothoracic transplant and VAD.
心理社会评估在小儿患者胸器官移植或心室辅助装置（VAD）植入的多学科评估中起着至关重要的作用。然而，在评估的内容和过程方面存在很大的实践差异，且近期尚无已知的发布指南。此外，小儿评估在许多实质性方面必然不同于成人评估，包括照顾者的角色和决策制定。一个由25名小儿心胸移植/VAD多学科专家组成的写作委员会成立了，他们进行了全面的文献综述，从而制定了这个基于共识的框架。该框架是国际心肺移植学会（ISHLT）、国际小儿移植协会（IPTA）、小儿心脏移植学会（PHTS）、推进心脏治疗改善结局网络（ACTION）和移植家庭的共同努力成果，是已知的第一个针对小儿心胸移植/VAD心理社会评估的内容和过程的框架。评估过程中考虑了小儿评估过程中固有的相关伦理、文化和健康公平因素。目标不是提供一个规定性的评估过程，而是创建一个灵活的框架，以鼓励各中心之间保持一致，同时也承认在评估儿童及其家庭进行心胸移植和VAD时所固有的复杂性。
