title: Transition to adult care for pediatric liver transplant recipients: the Western Australian experience.
abstract: 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.
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, WA, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Mitchell
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, WA, Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Gooding
authors.affiliation: Department of Gastroenterology, Princess Margaret Hospital for Children, Perth, WA, Australia.
authors.forename: Cathy
authors.initials: C
authors.lastname: Mews
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, WA, Australia.|School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.
authors.forename: Leon
authors.initials: L
authors.lastname: Adams
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, WA, Australia.|School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.
authors.forename: Gerry
authors.initials: G
authors.lastname: MacQuillan
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, WA, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Garas
authors.affiliation: Department of Gastroenterology, Princess Margaret Hospital for Children, Perth, WA, Australia.
authors.forename: Madhur
authors.initials: M
authors.lastname: Ravikumara
authors.affiliation: Department of Gastroenterology, Princess Margaret Hospital for Children, Perth, WA, Australia.
authors.forename: Ainslie
authors.initials: A
authors.lastname: Lopez
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, WA, Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Collins
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, WA, Australia.|School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.
authors.forename: Gary
authors.initials: G
authors.lastname: Jeffrey
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017093:Liver Failure / Q000523:psychology / Q000601:surgery; D016031:Liver Transplantation / Q000523:psychology; D008297:Male; D055118:Medication Adherence; D010349:Patient Compliance; D012189:Retrospective Studies; D060305:Transition to Adult Care; D066027:Transplant Recipients; D016896:Treatment Outcome; D014904:Western Australia; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents
keywords: Australia; adherence; liver transplantation; pediatric; transition