Pediatric Heart Transplantation: Transitioning to Adult Care (TRANSIT): Feasibility of a Pilot Randomized Controlled Trial

Overview

Journal J Card Fail

Specialty Cardiology & Vascular Diseases

Date 2019 Jul 6

PMID 31276804

Citations 8

Authors

Kathleen L Grady

Adin-Cristian Andrei

Tamara Shankel

Richard Chinnock

Shelley D Miyamoto

Amrut V Ambardekar

Allen Anderson

Linda Addonizio

Farhana Latif

Debra Lefkowitz

Lee R Goldberg

Seth A Hollander

Michael Pham

Kathleen Vant Hof

Jill Weissberg-Benchell

Clyde Yancy

Menghan Liu

Nichole Melody

Elfriede Pahl

Affiliations

Soon will be listed here.

Abstract

Background: Young-adult heart transplant recipients transferring to adult care are at risk for poor health outcomes. We conducted a pilot randomized controlled trial to determine the feasibility of and to test a transition intervention for young adults who underwent heart transplantation as children and then transferred to adult care.

Methods: Participants were randomized to the transition intervention (4 months long, focused on heart-transplant knowledge, self-care, self-advocacy, and social support) or usual care. Self-report questionnaires and medical records data were collected at baseline and 3 and 6 months after the initial adult clinic visit. Longitudinal analyses comparing outcomes over time were performed using generalized estimating equations and linear mixed models.

Results: Transfer to adult care was successful and feasible (ie, excellent participation rates). The average patient standard deviation of mean tacrolimus levels was similar over time in both study arms and < 2.5, indicating adequate adherence. There were no between-group or within-group differences in percentage of tacrolimus bioassays within target range (> 50%). Average overall adherence to treatment was similarly good in both groups. Rates of appointment keeping through 6 months after transfer declined over time in both groups.

Conclusions: The feasibility of the study was demonstrated. Our transition intervention did not improve outcomes.

Citing Articles

Health care transition planning and outcomes: What's next?.

Betz C, Diaz-Gonzalez de Ferris M Health Care Transit. 2024; 2:100045.

PMID: 39712591 PMC: 11657942. DOI: 10.1016/j.hctj.2024.100045.

Patient navigator programmes for children and adolescents with chronic diseases.

Lalji R, Koh L, Francis A, Khalid R, Guha C, Johnson D Cochrane Database Syst Rev. 2024; 10:CD014688.

PMID: 39382077 PMC: 11462635. DOI: 10.1002/14651858.CD014688.pub2.

Modification and scoring of a transition tool to understand transition readiness among pediatric kidney transplant recipients.

Peterson C, Bitterfeld L Pediatr Nephrol. 2024; 40(1):223-230.

PMID: 39240281 DOI: 10.1007/s00467-024-06497-0.

The improving Medication Adherence in Adolescents and young adults following Liver Transplantation (iMALT) multisite trial: Design and trial implementation considerations.

Shemesh E, Duncan-Park S, Mazariegos G, Annunziato R, Anand R, Reyes-Mugica M Clin Trials. 2023; 20(5):528-535.

PMID: 37269062 PMC: 10524899. DOI: 10.1177/17407745231176834.

Are we ready for building transition programs for heart transplant recipients in Japan? - Knowing the unique background is the first step for discussion.

Kato T, Gomi H, Aizawa Y, Kawamura A, Eisen H, Hunt S Front Pediatr. 2022; 10:935167.

PMID: 36405837 PMC: 9671939. DOI: 10.3389/fped.2022.935167.

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