儿科肝移植后的监测实践
Voytek Slowik1, Jamie L Ryan1, Amit A Shah2
1From the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children's Mercy Kansas City, Kansas City, MO.
Journal of pediatric gastroenterology and nutrition
|August 7, 2023
概括
儿科肝移植 (LT) 监测有很大差异,大多数中心在第一年后减少了随访. 监测活检和常规成像是不常见的,强调需要基于结果的最佳实践指南.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 移植肝病学 移植肝病学
- 临床实践指南 临床实践指南
背景情况:
- 儿科肝移植 (LT) 后的护理需要标准化的监测协议.
- 目前对LT后的随访诊所,实验室检测,活检和成像检查的现实实践还没有很好地定义.
- 了解LT管理的变化对于改善患者的治疗结果至关重要.
研究的目的:
- 评估儿科肝移植当前的监测实践.
- 确定影响LT后管理的中心和提供商特征.
- 为制定基于证据的儿科LT护理指南建立基线.
主要方法:
- 分发给儿科LT提供者的横截面调查.
- 从参与儿科肝移植协会 (SPLIT) 注册中心收集的数据.
- 调查于2020年2月至2021年4月期间进行,达到79%的响应率.
主要成果:
- 在LT后的诊所访问和实验室监测频率存在显著差异.
- 在第一年之后,每年一次的诊所检查和每季度一次的实验室检查是常见的.
- 监测性肝活检在第一年内很少进行,但随后很常见;成像通常是按需的.
结论:
- 儿科肝移植中心在移植后的管理策略中表现出相当大的多样性.
- 虽然存在一些常见的做法,但仍然存在显著的变化,特别是在最初的一年之后.
- 需要进一步的研究来将特定的监测协议与患者的结果联系起来,并定义最佳的护理途径.
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