An empirically based practice perspective on the transition to adulthood for solid organ transplant recipients

Abstract

Preparing patients for transitioning to self-managed care and subsequently transferring to the adult healthcare system has become a critical process for clinicians working with pediatric transplant recipients. This paper reviews several barriers to a successful transition. These include patient barriers, caregiver barriers, and considerations within pediatric and adult centers. To date, few approaches for improving the transition process have been empirically tested. This review details studies that have examined possible models including usage of a transition coordinator and transition clinics. Recommendations are offered to promote an optimal transition including the importance and content of preparation, assessing and addressing transition readiness, insuring the involvement of all stakeholders, and finally, at minimum providing services during the transfer period. Future directions are offered aiming to advance this important area of investigation.

Transition readiness, adolescent responsibility, and executive functioning among pediatric transplant recipients: Caregivers' perspectives

“…Healthcare transition has been conceptualized as both a process and an event that consists of adolescents assuming increasing responsibility for self‐managing their health care (ie, process) and the eventual transfer from pediatric to adult medical services (ie, event). Numerous factors have been identified as playing a role in youth's readiness to transition, including age, sociodemographic and cultural variables, aspects of psychosocial and family functioning, allocation of treatment responsibility, communication between providers, and insurance coverage/financial difficulties among others . Concerns across the transition period are particularly salient for pediatric transplant recipients due to the serious consequences of poor transition planning.…”

Barriers to ideal outcomes after pediatric liver transplantation

“…48 Uninformed transition and transfer practices may negatively impact successful selfmanagement, adherence, and-ultimately-graft survival. [49][50][51] Recommendations • Perform studies that define metrics of a "successful" transition.…”

The management of childhood liver diseases in adulthood

“…Therefore, transfer, is but a component of transition. Transition, on the other hand is not a single event but a purposeful, planned process of moving adolescents and young adults with chronic medical and physical conditions from a child centre to an adult-orientated health care system [5,6]. It is an important milestone for patients, families, carers, and paediatric and adult services as well as potentially representing a period of vulnerability for the individual patient.…”