Adult provider role in transition of care for young adult pediatric recipients of liver transplant: An expert position statement

Author:

Vittorio Jennifer1,Kosmach-Park Beverly2,Wadhwani Sharad3,Jackson Whitney4,Kerkar Nanda5,Corbo Heather6,Vekaria Pooja7,Gupta Nitika8,Yeh Heidi9,King Lindsay Y.10

Affiliation:

1. Department of Pediatrics, New York University (NYU) Transplant Institute, NYU Langone Health, New York, New York, USA

2. Department of Transplant Surgery, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA

3. Department of Pediatrics, University of California-San Francisco, San Francisco, California, USA

4. Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA

5. Department of Pediatrics, University of Rochester Medical Center, New York, New York, USA

6. Department of Pharmacy, New York-Presbyterian Hospital, New York, New York, USA

7. Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA

8. Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA

9. Division of Transplant Surgery, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA

10. Division of Gastroenterology, Department of Medicine, Duke University Health System, Durham, North Carolina, USA

Abstract

Health care transition (HCT) is the process of changing from a pediatric to an adult model of care. Young adult pediatric recipients of liver transplant transferring from pediatric to adult health care services are highly vulnerable and subject to poor long-term outcomes. Barriers to successful transition are multifaceted. A comprehensive HCT program should be initiated early in pediatrics and continued throughout young adulthood, even after transfer of care has been completed. It is critical that pediatric and adult liver transplant providers establish a partnership to optimize care for these patients. Adult providers must recognize the importance of HCT and the need to continue the transition process following transfer. While this continued focus on HCT is essential, current literature has primarily offered guidance for pediatric providers. This position paper outlines a framework with a sample set of tools for the implementation of a standardized, multidisciplinary approach to HCT for adult transplant providers utilizing “The Six Core Elements of HCT.” To implement more effective strategies and work to improve long-term outcomes for young adult patients undergoing liver transplant, HCT must be mandated as a routine part of posttransplant care. Increased advocacy efforts with the additional backing and support of governing organizations are required to help facilitate these practices.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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