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Published on: April 12, 2021
Transition from pediatric to adult care after solid organ transplantation
Janet E McDonagh1, Miriam Kaufman
1University of Birmingham, Birmingham, UK. j.e.mcdonagh@bham.ac.uk
Insights
Improved survival in young solid organ transplant recipients highlights the need for effective transition to adult care. Current transitional care shows suboptimal adherence to guidelines, emphasizing the need for further research and collaboration.
Area of Science:
- Medical Science
- Transplant Surgery
- Adolescent Medicine
Background:
- Improved survival rates in young solid organ transplant recipients necessitate a focus on healthcare transition.
- The move from pediatric to adult-centered care services presents unique challenges for transplant patients.
Purpose of the Study:
- To review current evidence and position statements on issues related to healthcare transition in solid organ transplantation.
- To identify challenges and areas for improvement in transitional care for young transplant recipients.
Main Methods:
- Systematic review of recent studies.
- Analysis of position statements regarding transitional care.
Main Results:
- Universal agreement exists on the philosophy of transitional care, but adherence to published guidance is suboptimal across disciplines.
- A lack of routine adolescent health screening indicates a need for adolescent medicine integration.
- Preliminary work on adherence and self-management requires further validation through larger trials.
Conclusions:
- Transitional care is essential for young solid organ transplant recipients.
- Further research is needed on evaluating interventional models, transition readiness, and multidimensional outcomes.
- Collaboration across specialties is crucial for advancing transitional care research.
Purpose Of Review:
The transition of healthcare for young people with solid organ transplants as they move into adult-centered services has become more significant over recent years as survival has improved. This review examines evidence from recent studies and position statements to determine the current issues relating to transition and transplantation.
Recent Findings:
Although there is a universal agreement of the philosophy of transitional care, there is suboptimal adherence to published guidance across disciplines. Similarly, a lack of routine adolescent health screening emphasizes the need for adolescent medicine within transition programs. Interesting preliminary work addressing other aspects of the process transition, namely adherence assessment and promotion and self-management training, awaits data from larger controlled trials.
Summary:
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!
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