14:00 - 15:30
Oral session
Room: Farabeuf
Chair/s:
Yaron Avitzur, Simon Gabe
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Effective transitioning of adolescents into adult intestinal transplant services – survey of NITE members
Philip Allan 1, 2, Lindsay Hogg 3, Monica Smith 3, Heather Howe 2, Lisa Vokes 4, Alison Smith 2, Jane Hartley 3, Georgios Vrakas 2, Srikanth Reddy 2, Peter Friend 2, Girish Gupte 3
1 Translational Gastroneterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
2 Oxford Transplant Centre, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK
3 Intestinal Transplant Centre, Birmingham Children's and Women's Hospital, Birmingham, UK
4 Department of Dietetics, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK

Introduction: Transition of paediatric intestinal transplant recipients is important in allowing patients and their families a continuum of care from current paediatric team to an adult team. In some cases this may be within the same hospital/organisation, and at other times may be to other centres nationally. The long-term outcome and well-being of adolescent patients is clearly much better in terms of compliance and longevity if trust is built up between the patient and the adult centre with the familiarity of their paediatric teams. Over the past 3 years we have transitioned 8 paediatric patients over the age of 18. We have learnt from having a dedicated discussion with transition nurse and psychologist empowers the patient and families towards a smooth transition journey from paediatric to adult centres.

Method: We undertook a survey of members of the NITE network to understand how transition occurs and what typical problems are encountered. A 10 question survey was sent using Surveymonkey

Results: From the survey 19/60 (32%) individuals invited responded from 16 centres across Europe. 8/19 (42%) were from a paediatric centre, 8/19 (42%) were from a combined centre and 3/19 (16%) were from adult only. The majority (84%) had a policy for transitioning patients, over 60% thought about commencing transition when patients were aged 14-18, but majority (57%) started transitioning at 16-18, and the first combined clinic was only 31% 16-18 but 48% >18yrs. The majority of responses did not have access to a dedicated transition nurse (63%) or psychologist (63%). Lastly, majority of endoscopic procedures were carried out using propofol or GA (63%).

Conclusion: From our experience, transition needs careful planning, a dedicated team to facilitate and early conversations to ensure adolescents are ready to transition effectively. This will require centres to develop extended roles for multi-disciplinary team to support transition, eg dedicated nurse and psychologist, but also start transitioning patients to the same endoscopic strategy that adults undertake and consider appropriate immunosuppression when adolescents may be considering starting a family.

Session:
Management of intestinal failure. Home parenteral nutrition
Presenter/s:
Philip Allan
Presentation type:
Oral only presentation
Room:
Farabeuf
Chair/s:
Yaron Avitzur, Simon Gabe
Date:
Thursday, July 4, 2019
Time:
14:00 - 15:30
Session times:
14:00 - 15:30
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