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

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 Van't Hof, Jill Weissberg-Benchell, Clyde Yancy, Menghan Liu, Nichole Melody, Elfriede Pahl

Research output: Contribution to journalArticle

2 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)948-958
Number of pages11
JournalJournal of Cardiac Failure
Volume25
Issue number12
DOIs
StatePublished - Dec 2019
Externally publishedYes

Keywords

  • Heart transplantation
  • Transition program

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Grady, K. L., Andrei, A. C., Shankel, T., Chinnock, R., Miyamoto, S. D., Ambardekar, A. V., Anderson, A., Addonizio, L., Latif, F., Lefkowitz, D., Goldberg, L. R., Hollander, S. A., Pham, M., Van't Hof, K., Weissberg-Benchell, J., Yancy, C., Liu, M., Melody, N., & Pahl, E. (2019). Pediatric Heart Transplantation: Transitioning to Adult Care (TRANSIT): Feasibility of a Pilot Randomized Controlled Trial. Journal of Cardiac Failure, 25(12), 948-958. https://doi.org/10.1016/j.cardfail.2019.06.011