Rebekka Salonen, Kira Endén, Mikael Koskela, Kirsi Jahnukainen, Atte Nikkilä, Timo Jahnukainen
{"title":"儿童实体器官移植后多种用药的用药和风险——一项全国登记研究","authors":"Rebekka Salonen, Kira Endén, Mikael Koskela, Kirsi Jahnukainen, Atte Nikkilä, Timo Jahnukainen","doi":"10.1111/ctr.70256","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Solid organ transplant (SOT) recipients are at risk for long-term comorbidities and polypharmacy, potentially affecting quality of life. This study assessed the prevalence of chronic medication use among young adults following pediatric SOT.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We included 215 individuals in Finland who underwent kidney (<i>n</i> = 135), liver (<i>n</i> = 41), or heart (<i>n</i> = 39) transplantation before age 16 between 1982 and 2015 and were ≥18 years at follow-up. Age, sex, and hometown-matched controls (<i>n</i> = 1067) were selected from the Finnish Population Information System. The analyses involved data on prescription drug purchases and reimbursements for chronic conditions derived from the registry of Social Insurance Institution, which covers all prescription medicine purchases in Finland.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The SOT recipients had an average of 1.53 reimbursed chronic conditions beyond immunosuppression (median follow-up time:18.0 years, IQR 11.0–23.0), with the highest burden among kidney and lowest among liver transplant recipients. Compared to controls, SOT recipients had significantly more reimbursement for cardiovascular diseases, hormonal deficiencies, and epilepsy (<i>p</i> < 0.001). Kidney transplant recipients had a significantly higher risk of cardiovascular-related reimbursements than liver transplant group (<i>p</i> < 0.001); no significant differences were observed between the transplant groups for other conditions.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Young adults after pediatric SOT had an elevated need for chronic disease medications, with the highest burden observed in kidney transplant recipients and the lowest in liver transplant recipients. These findings highlight the importance of long-term follow-up and individualized transitional care to address multimorbidity and support quality of life.</p>\n </section>\n </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70256","citationCount":"0","resultStr":"{\"title\":\"Drug Usage and Risk for Polypharmacy After Pediatric Solid Organ Transplantation—A National Register Study\",\"authors\":\"Rebekka Salonen, Kira Endén, Mikael Koskela, Kirsi Jahnukainen, Atte Nikkilä, Timo Jahnukainen\",\"doi\":\"10.1111/ctr.70256\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Solid organ transplant (SOT) recipients are at risk for long-term comorbidities and polypharmacy, potentially affecting quality of life. This study assessed the prevalence of chronic medication use among young adults following pediatric SOT.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We included 215 individuals in Finland who underwent kidney (<i>n</i> = 135), liver (<i>n</i> = 41), or heart (<i>n</i> = 39) transplantation before age 16 between 1982 and 2015 and were ≥18 years at follow-up. Age, sex, and hometown-matched controls (<i>n</i> = 1067) were selected from the Finnish Population Information System. The analyses involved data on prescription drug purchases and reimbursements for chronic conditions derived from the registry of Social Insurance Institution, which covers all prescription medicine purchases in Finland.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The SOT recipients had an average of 1.53 reimbursed chronic conditions beyond immunosuppression (median follow-up time:18.0 years, IQR 11.0–23.0), with the highest burden among kidney and lowest among liver transplant recipients. Compared to controls, SOT recipients had significantly more reimbursement for cardiovascular diseases, hormonal deficiencies, and epilepsy (<i>p</i> < 0.001). Kidney transplant recipients had a significantly higher risk of cardiovascular-related reimbursements than liver transplant group (<i>p</i> < 0.001); no significant differences were observed between the transplant groups for other conditions.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Young adults after pediatric SOT had an elevated need for chronic disease medications, with the highest burden observed in kidney transplant recipients and the lowest in liver transplant recipients. These findings highlight the importance of long-term follow-up and individualized transitional care to address multimorbidity and support quality of life.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10467,\"journal\":{\"name\":\"Clinical Transplantation\",\"volume\":\"39 8\",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-07-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70256\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Transplantation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/ctr.70256\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Transplantation","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ctr.70256","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Drug Usage and Risk for Polypharmacy After Pediatric Solid Organ Transplantation—A National Register Study
Background
Solid organ transplant (SOT) recipients are at risk for long-term comorbidities and polypharmacy, potentially affecting quality of life. This study assessed the prevalence of chronic medication use among young adults following pediatric SOT.
Methods
We included 215 individuals in Finland who underwent kidney (n = 135), liver (n = 41), or heart (n = 39) transplantation before age 16 between 1982 and 2015 and were ≥18 years at follow-up. Age, sex, and hometown-matched controls (n = 1067) were selected from the Finnish Population Information System. The analyses involved data on prescription drug purchases and reimbursements for chronic conditions derived from the registry of Social Insurance Institution, which covers all prescription medicine purchases in Finland.
Results
The SOT recipients had an average of 1.53 reimbursed chronic conditions beyond immunosuppression (median follow-up time:18.0 years, IQR 11.0–23.0), with the highest burden among kidney and lowest among liver transplant recipients. Compared to controls, SOT recipients had significantly more reimbursement for cardiovascular diseases, hormonal deficiencies, and epilepsy (p < 0.001). Kidney transplant recipients had a significantly higher risk of cardiovascular-related reimbursements than liver transplant group (p < 0.001); no significant differences were observed between the transplant groups for other conditions.
Conclusions
Young adults after pediatric SOT had an elevated need for chronic disease medications, with the highest burden observed in kidney transplant recipients and the lowest in liver transplant recipients. These findings highlight the importance of long-term follow-up and individualized transitional care to address multimorbidity and support quality of life.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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