新生児期に肝移植が必要になる家族への精神的・社会的サポートの重要性

• 尾沼 恵梨香

  自治医科大学附属病院移植・再生医療センター

• 眞田 幸弘

  自治医科大学移植外科

• 吉田 幸世

  自治医科大学附属病院移植・再生医療センター

• 浦橋 泰然

  自治医科大学移植外科

• 井原 欣幸

  自治医科大学移植外科

• 岡田 憲樹

  自治医科大学移植外科

• 山田 直也

  自治医科大学移植外科

• 平田 雄大

  自治医科大学移植外科

• 片野 匠

  自治医科大学移植外科

• 大友 慎也

  自治医科大学附属病院薬剤部

• 牛島 健太郎

  自治医科大学臨床薬理学部門

• 水田 耕一

  自治医科大学移植外科

書誌事項

タイトル別名

• The importance of mental and social support for families with a child requiring liver transplantation because of neonatal fulminant hepatic failure

抄録

【Objective】There are two medical aspects regarding living donor liver transplantation (LDLT) for neonatal fulminant hepatic failure (FHF) : namely, neonatal and transplant medical care. We evaluated the specificity and issues of neonatal LDLT based on what we experienced at our institution.<br/>【Methods】The study subjects included eight cases of neonatal FHF and 128 cases of other original diseases that underwent LDLT at our institution during the period from October 2008 to September 2015. Information on the family structure, social background, and psychological changes of family members during the perioperative period was retrospectively collected from the medical records, and the specificity and issues of neonatal LDLT were then analyzed.<br/>【Results】The original diseases consisted of neonatal hemochromatosis in six patients, an unknown etiology in one, and Niemann-Pick type C in one. The median age of onset, age at LDLT, and current age were 0 days （0-19 days）, 32 days （9-59 days）, and 4.3 years old （1-7 years old）, respectively. The donors were the fathers in seven cases and the mothers in two, with the mothers being donors for cases in which the disease developed in siblings and in which the patient required retransplantation.<br/>The median period of hospitalization was 98 days （40-631 days）, indicating a longer hospitalization period compared to patients with other original diseases. The neurological sequelae comprised visual impairment due to vitreous hemorrhage in one patient, hearing impairment due to an unknown etiology in one, and psychomotor retardation in one.<br/>Three of the cases were first-born children; thus some problems were associated with parent training, and these parents required special assistance when the patients were discharged. On the other hand, in the non-first-born child cases there was less anxiety regarding parent training, and they required no special assistance at the time of discharge because of the parents' previous experience and family support system that was established while taking care of the patient's siblings.<br/>【Conclusions】Regarding the families requiring neonatal LDLT, it is necessary for the transplant coordinator to carefully advise the family before LDLT and help them to establish their mental and social support system; specifically, if the patient is a first-born child, early intervention and support are essential.

収録刊行物

• 移植

  移植 51 (4-5), 405-410, 2016

  一般社団法人 日本移植学会

キーワード

• neonatal fulminant hepatic failure
• neonatal care
• medical care
• living donor liver transplantation (LDLT)
• first child

詳細情報

• CRID: 1390001205510098176
• NII論文ID: 130005433155
• DOI: 10.11386/jst.51.4-5_405
• ISSN: 21880034
• ISSN: 05787947
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可