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

• Published in: Pediatrics (Evanston) 2011-04, Vol.127 (4), p.742-753
• Main Authors: LAROSA, Christopher, GLAH, Caryle, BALUARTE, H. Jorge, MEYERS, Kevin E. C
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adolescent; Adult; Biological and medical sciences; Child; Cognition Disorders - diagnosis; Cognition Disorders - psychology; Cognition Disorders - therapy; Complications and side effects; Cooperative Behavior; Demographic aspects; Disability Evaluation; Effects; General aspects; Graft Rejection - diagnosis; Graft Rejection - psychology; Graft Rejection - therapy; Health Services Accessibility; Health Services Needs and Demand; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Independent Living - psychology; Insurance Coverage; Interdisciplinary Communication; Medical personnel; Medical sciences; Medical treatment; Medication Adherence - psychology; Miscellaneous; Organ transplantation; Organ Transplantation - psychology; Patient Care Team; Patient outcomes; Pediatrics; Personal Autonomy; Postoperative Complications - diagnosis; Postoperative Complications - psychology; Postoperative Complications - therapy; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of Life - psychology; Referral and Consultation; Social Adjustment; Survivors; Transfer Agreement; Transitional care; Transplantation of organs, tissues, etc; Transplants & implants; Young Adult
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2010-1232

Pediatric solid-organ transplantation is an increasingly successful treatment for solid-organ failure. With dramatic improvements in patient survival rates over the last several decades, there has been a corresponding emergence of complications attributable to pretransplant factors, transplantation itself, and the management of transplantation with effective immunosuppression. The predominant solid-organ transplantation sequelae are medical and psychosocial. These sequelae have a substantial effect on transition to adult care; as such, hurdles to successful transition of care arise from the patients, their families, and pediatric and adult health care providers. Crucial to successful transitioning is the ongoing development of a sense of autonomy and responsibility for one's own care. In this article we address the barriers to transitioning that occur with long-term survival in pediatric solid-organ transplantation. Although a particular transitioning model is not promoted, practical tools and strategies that contribute to successful transitioning of pediatric patients who have received a transplant are suggested.