Transition from pediatrics to adults: how adolescents with solid organ transplantation move to adult care in a general hospital
Maria Sanchez1, Sara Vainman2, María M María Martina Heller,2, Lucía Lucía Perez4, Valleria Mulli2, Carmen de Cunto3.
1GI Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; 2Adolescence, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; 3Rheumatology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; 4Pediatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Objectives: To describe the experience of a transition program for solid organ transplant (SOT) patients from pediatric to adult care in a general hospital. To assess readiness for transition to adults using the validated TRAQ questionnaire.
Methods: A descriptive retrospective cross-sectional study of patients aged 16-24 years with a history of liver transplantation (LT) or renal transplantation (RT) attended at the Hospital Italiano de Buenos Aires in the period 2015-2019 was performed.
Results: A total of 157 patients were included, RT 69.4% (109) and LT 30.6% (48). 37% (59/157) [95%CI 32-42] of patients had participated in the transition program. Mean years of follow-up by the LT team of those who underwent transition was 11 years (SD 7.3) while those who did not undergo planned transition was 12 years (SD 7.2) and in the RT team it was 7.3 (SD 3.9) and of those who did not plan transition 9.3 years (SD 4.9) (p0.01). The mean age at the beginning of transition in LT was 17.3 years (SD 1.5) and in RT was 20.7 years (SD 2.4) and the mean age at the end of transition was 21.5 in LT (DS 1.8) and in RT was 22 years (SD 2.4). Sixty-four percent of those who transitioned (37/59) had a record of the problem "Transition from pediatrics to adults" and 90% (53/59) had a record of the transition process in the medical electronic registry. The most frequent transition strategy was shared Clinic with the pediatric and adult care time in 96% (57/59). Forty-four percent of patients participating in the transition program (26/59) had the TRAQ questionnaire loaded in the medical electronic registry. The median ordinal TRAQ was 4 (between 3 and 4). The adult stay rate was 87% (51/59), there were no non-relevant adult emergency consultations and the median number of professionals consulted before reaching the referring physician was 1 (SD 0.67).
Conclusions: This study evidences the need to form planned transition programs together with the use of validated tools to measure the autonomy and responsibility skills of young adults with medical chronic conditions, capable of making informed decisions about their future health.
right-click to download