Abstract:

Objective To systematically summarize the long-term follow-up strategy for pediatric liver transplantation constructed by Tianjin First Central Hospital，analyze its application effects in ensuring patient survival，improving follow-up adherence，and accurately detecting complications，so as to provide a replicable practical reference for clinical follow-up management after pediatric liver transplantation. Methods A retrospective study was conducted，including 1 967 pediatric liver transplant patients in Tianjin First Central Hospital from 2013 to 2024. A long-term follow-up strategy of“standardized follow-up procedure + multidisciplinary team（MDT）+ information platform”was established. Kaplan-Meier method was used to calculate patient and graft survival rates，and Logistic regression analysis was performed to identify factors influencing follow-up status. Results The1-year，5-year and 10-year patient survival rates were 95.6%、94.1% and 93.8%，respectively，while the 1-year，5-year and 10-year graft survival rates were 94.4%，92.6% and 90.2%，respectively. The regular follow-up rate was91.68%，the pure loss to follow-up rate was 2.07%，and 96 .4% of patients from other provinces received standardized follow-up through the information platform. Multivariate Logistic regression analysis showed that only "postoperativefollow-up time" was an independent risk factor affecting follow-up status（OR＝1.433，95% CI＝1.208～1.700， P＜0.001）. Conclusion The long-term follow-up strategy of "standardized follow-up procedure + MDT + information platform" constructed by our center can effectively ensure long-term patient survival，improve follow-up adherence，and accurately identify late high-risk complications. It is particularly suitable for the clinical situation in China with a high proportion of remote patients，and has important clinical promotion value.

Key words:

"> Pediatric liver transplantation, Postoperative follow-up strategy, Survival rate, Followup adherence in remote patients

摘要：

目的 系统总结天津市第一中心医院构建的儿童肝移植术后长期随访策略，分析其在患者生存保障和随访依从性提升中的应用成效，为临床儿童肝移植术后随访管理提供可复制的实践参考。方法 回顾性纳入2013 —2024 年在天津市第一中心医院1 967 例儿童肝移植患者资料，构建“标准化随访程序+ 多学科团队（multidisciplinary team，MDT）+ 信息化平台”长期随访策略，采用KaplanMeier 法计算患者及移植物生存率，Logistic 回归分析影响随访状态的因素。 结果 患者1、5、10 年生存率分别为95.6%、94.1%、93.8%，移植物1、5、10 年生存率分别为94.4%、92.6%、90.2%。规律随访率达91.68%，单纯失访率达2.07%，96.4% 外省市患者通过信息化平台获规范随访。多因素Logistic 回归分析显示，仅“术后随访时间”为影响随访状态的独立危险因素（OR＝1.433，95% CI＝1.208～1.700， P＜0.001）。结论 构建“标准化随访程序+ MDT + 信息化平台”长期随访策略，可保障患者长期生存、提升随访依从性、精准识别晚期高危并发症，尤其适配我国异地患者占比高的临床现状，具有重要的临床推广价值。

关键词: 儿童肝移植,  , 术后随访策略,  , 生存率,  , 异地随访