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Transitioning Pediatric Surgical Patients to Adult Surgical Care A Call to Action

Stefano Giuliani, MD, PhD1; Dean M. Anselmo, MD2
[+] Author Affiliations
1Department of Pediatric and Neonatal Surgery, St George’s Healthcare NHS Trust and University of London, London, England
2Department of Pediatric Surgery, Children’s Hospital Los Angeles, University of Southern California, Los Angeles
JAMA Surg. 2014;149(6):499-500. doi:10.1001/jamasurg.2013.4848.
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Over the past 50 years, there has been a significant improvement in the outcomes for children with many complex congenital or acquired surgical conditions such as heart disease, gastroschisis, diaphragmatic hernia, anorectal malformations, spina bifida, and intestinal failure. As a result, the adult health care system is receiving a growing number of young adults, with chronic surgical issues, requiring lifelong assistance within a multidisciplinary model of care. In this emerging scenario, transitional care is vital for adolescents and young adults with active chronic surgical and medical problems who will require care from knowledgeable and well-trained adult physicians. In 2002, the American Academy of Pediatrics established that “the goal of a planned health care transition is to maximize lifelong functioning and well-being for all youth”1(p1304) and that transitional care is “a purposeful, planned process that addresses the medical, psychosocial and educational/vocational needs of adolescents and young adults with chronic physical and medical conditions as they move from child-centered to adult-oriented healthcare systems.”2(p571) An unsuccessful surgical transition may result in physical and mental health implications for young patients, negative long-term outcomes, and suboptimal use of health care resources.3

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