TRANSITION of Pediatric Liver Transplant Patients to Adult Care: a Review.
James P StevensLori HallNitika Arora GuptaPublished in: Current gastroenterology reports (2021)
While results were variable between studies, many recent reports show significant morbidity and mortality in patients following transition to adult care. Medical non-adherence is frequently seen in adolescents and young adults both prior to and after transition, and is consistently associated with higher rates of rejection, graft loss, and death. In general, transplant programs with a formal transition process had better patient outcomes though recent findings are mostly-single center and direct comparison between programs is difficult. Societal recommendations for how to create a transition program contain a number of common themes that we have categorized for easier understanding. Successful transition is vital to the continued health of pediatric liver transplant patients. While an effective transition program includes a number of key components, it should be individualized to best function within a given transplant center. Here, we have reviewed a number of recent single-center retrospective studies on transition, but multi-site retrospective or prospective data is lacking, and is a fertile area for future research.
Keyphrases
- end stage renal disease
- healthcare
- ejection fraction
- newly diagnosed
- chronic kidney disease
- prognostic factors
- quality improvement
- emergency department
- risk assessment
- patient reported outcomes
- metabolic syndrome
- machine learning
- pain management
- electronic health record
- climate change
- clinical practice
- skeletal muscle
- childhood cancer
- affordable care act