Premium
Transition to adult care for pediatric liver transplant recipients: the Western Australian experience
Author(s) -
Mitchell Tim,
Gooding Hannah,
Mews Cathy,
Adams Leon,
MacQuillan Gerry,
Garas George,
Ravikumara Madhur,
Lopez Ainslie,
Collins Megan,
Jeffrey Gary
Publication year - 2017
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12820
Subject(s) - medicine , psychosocial , attendance , retrospective cohort study , liver transplantation , cohort , population , young adult , pediatrics , immunosuppression , cohort study , transplantation , gerontology , psychiatry , environmental health , economics , economic growth
Transition to adult care is a vulnerable period for pediatric transplant recipients and is associated with reduced medication compliance, graft loss, and increased mortality. Psychosocial outcomes in young adults differ between pediatric transplant recipients and their healthy peers. We conducted a single‐center, retrospective cohort study of all pediatric liver transplant recipients who were transitioned through our center. This study aimed to assess the outcomes of transitioned pediatric liver transplant recipients at an Australian center, including mortality, adherence, and psychosocial morbidity. The 1‐ and 5‐year survival rates following transition were 100% and 92%, respectively. There were no episodes of late rejection. In total, 66.7% of patients were compliant with immunosuppression and 61.1% of patients were compliant with clinic attendance. There was a significant relationship between medication compliance and clinic attendance, as well as presence of psychological issues with clinic non‐attendance. Psychosocial outcomes were in keeping with age‐matched data from the general population. All patients were employed or studying following transition. This is the first study of its kind in the Australian population, and outcomes were superior to published international data. Despite the demonstrated good outcomes, transition programs may improve healthcare engagement in this cohort.