Transition from pediatric to adult care after solid organ transplantation

Abstract

There is now no doubt in the need for transitional care, but further research is required into the objective evaluations of interventional models, the determinants of transition readiness and the multidimensional assessment of outcome. This factor is true for any chronic condition, and clinicians and researchers should ensure that they look outside their 'specialty box' from time to time and take advantage of the wealth of experience of and evidence from others in the transitional care arena. If we want to move transitional care research forward, collaboration is the key!

A systematic review of transition readiness and transfer satisfaction measures for adolescents with chronic illness

“…While a successful transition is associated with positive health outcomes, a poorly planned transfer can be associated with increased risk of treatment non-adherence and lack of follow-up. This can lead to adverse consequences in terms of morbidity and mortality as well as social, educational and vocational outcomes (33)(34)(35)(36)(37). Thus, the key to a successful transfer is an adolescent's readiness to begin to transition.…”

Health-care transition from pediatric to adult-focused gastroenterology in patients with eosinophilic esophagitis

“…4 Interestingly, there have been no studies regarding HCT in EoE despite the large number of children and adolescents with this condition who will need adult providers as they age. However, review of the current HCT literature in patients with liver and solid organ transplant, 17–21 inflammatory bowel disease, 5, 22–24 cystic fibrosis, 25 chronic kidney disease, 6, 26–28 juvenile arthritis, 29 congenital heart disease, 30 and diabetes 31 reveals several recurring themes which are applicable to transition in EoE, including barriers to transitional care and program elements required for success. 21 …”

“…5, 6, 18, 19, 21, 23, 25, 29, 30, 32–38 Without an understanding of these barriers, design and implementation of a HCT program may be unsuccessful.…”

“…Normal adolescent behavior (rebellion; apathy; self-actualization; maturation; transition to independence from parents) 18, 19, 21, 32, 35 …”

Solid-Organ Transplantation in Childhood: Transitioning to Adult Health Care

“…Such children and their families represent an important underserved population, 5 as highlighted by the 2001 National Survey of Children With Special Health Care Needs, from which the core outcome "transition to adulthood" was reported as having the worst result (only 6% of children in the target population met this goal). 6 Although there are now policy statements and position papers [7][8][9] that call for a synchronized practical method to prepare young adults who have had a solid-organ transplant for a smooth transfer of medical care, current evidence suggests that many adolescents fail to meet this goal. A common need exists to improve the transition process, because many young adults are ill-equipped to receive care in the adult system.…”