Transition of Care for the Pediatric Transplant Recipient

The population of pediatric liver transplant recipients surviving into adulthood continues to increase, underscoring the need for structured, evidence-based transition services that address the vulnerabilities of adolescents and young adults. Transition is a longitudinal, developmentally informed process distinct from the act of transfer. Poorly executed transition contributes to nonadherence, late rejection, avoidable morbidity, graft loss, and mortality. This article reviews long-term outcomes after pediatric liver transplantation, key developmental and psychosocial factors affecting adherence, and medical and pharmacologic challenges. It also presents a framework for building an effective transition program grounded in the Six Core Elements of Health Care Transition.