This is an ongoing look at designing a pediatric to adult transition model and lessons learned over time. It has been shown that the first year of transition will have garnered increased instances of rejection, graft dysfunction, and death. Using ISHLT practice guidelines, Vanderbilt University Heart transplant program implemented such a transition program. We have revamped our program thru lessons learned with our first transition model. We have seven years of data gathered from 2010 to the present.

Benchmarks our program identified to measure the success of the transition were stable indicators for rejection with no rejection, clinical compliance with team recommendations, stable IS drug levels at goal range, positive patient satisfaction, continued stable mental health-minimal life change, scholastic or work goals with patient working toward or reaching goals within first year of transition, engagement with departmental return to work program, stable Quality of Life Benchmarks. Based on our experiences our program continues to show growth with program changes.

Patients ready for transition between the ages of 17-26 were identified by the pediatric team. These patients began the 18-24 month transition between the programs with an overlapping model for a short amount of time to ensure success with the transition. 45 patients thus far have made the transition from pediatrics to the adult program over the past seven years.

Year to date 45 patients has transitioned. The mean time post transplant has been 10-15 years. Age range has been from 20-26. There have been 9 reported deaths from non-compliance, cancer, suicide, and primary graft failure. 3 patients have been retransplanted from coronary graft vasculopathy. 1 patient is currently relisted for heart transplant due to coronary graft vasculopathy. 25 patients have successfully entered the work force or are attending college. 31 patients have been compliant with scheduled lab draws, clinic visits, and testing.

Results have shown continued success with in our transition program. We have learned that the transition model is made easier when the patient has been met on their “home turf” by the adult team to ease transition angst. It continues to be imperative that we continue our efforts to build an effective transitional care model and program for good life long outcomes and successful evidenced based practice without loss of life or graft function leading these young adults to have a fruitful and productive life.

CITATION INFORMATION: Adams S., Wigger M. A Single Center Transition of Care Model from Pediatric Heart Recipients to Adult Services Ongoing Study Model Am J Transplant. 2017;17 (suppl 3).

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