TY - JOUR
T1 - It takes a village
T2 - Primary care of the pediatric liver transplant recipient
AU - Hassan, Sara
AU - Ng, Vicky Lee
AU - Aqul, Amal
N1 - Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Purpose of reviewLong-Term survival is now the rule rather than the exception for infants and children who undergo liver transplantation for end-stage liver disease, metabolic liver conditions and a variety of other indications. Pediatricians and primary care providers play vital roles in the care and management of this patient population. The purpose of this review is to highlight key aspects important to the care of the pediatric liver transplant recipient.Recent findingsSignificant advances in immunosuppressive therapies and surgical techniques have contributed to improved graft and patient survival rates, shifting the focus beyond immediate survival to strategies to minimize comorbidities related to long-Term immunosuppression during growing years, attend to patient and parent-reported outcomes and enhance quality of life. A multidisciplinary approach allows for monitoring and surveillance of both routine (growth, nutritional rehabilitation, cognitive development, mental and psychosocial health, contraception and daily activities) and transplant-related (adverse effects of immunosuppression, susceptible infections, extra-hepatic systems, transition from childhood to adolescence to adulthood) themes.SummaryEffective communication between the primary care physician and the transplant team is imperative for optimizing best outcomes. The primary care provider should be aware of the multifacet nature of posttransplant management, which includes medication regimens, common complications and infections.
AB - Purpose of reviewLong-Term survival is now the rule rather than the exception for infants and children who undergo liver transplantation for end-stage liver disease, metabolic liver conditions and a variety of other indications. Pediatricians and primary care providers play vital roles in the care and management of this patient population. The purpose of this review is to highlight key aspects important to the care of the pediatric liver transplant recipient.Recent findingsSignificant advances in immunosuppressive therapies and surgical techniques have contributed to improved graft and patient survival rates, shifting the focus beyond immediate survival to strategies to minimize comorbidities related to long-Term immunosuppression during growing years, attend to patient and parent-reported outcomes and enhance quality of life. A multidisciplinary approach allows for monitoring and surveillance of both routine (growth, nutritional rehabilitation, cognitive development, mental and psychosocial health, contraception and daily activities) and transplant-related (adverse effects of immunosuppression, susceptible infections, extra-hepatic systems, transition from childhood to adolescence to adulthood) themes.SummaryEffective communication between the primary care physician and the transplant team is imperative for optimizing best outcomes. The primary care provider should be aware of the multifacet nature of posttransplant management, which includes medication regimens, common complications and infections.
KW - Vaccination
KW - immunosuppression
KW - pediatric liver transplantation
KW - primary care
UR - http://www.scopus.com/inward/record.url?scp=85071784551&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071784551&partnerID=8YFLogxK
U2 - 10.1097/MOP.0000000000000809
DO - 10.1097/MOP.0000000000000809
M3 - Review article
C2 - 31369476
AN - SCOPUS:85071784551
SN - 1040-8703
VL - 31
SP - 636
EP - 644
JO - Current opinion in pediatrics
JF - Current opinion in pediatrics
IS - 5
ER -