Growing up during the pandemic: A new look for transitioning to adult transplant care

Purpose: Adolescent and young adult (AYA) recipients of solid organ transplants (SOT) are confronted with a unique set of life stressors that may negatively impact allograft outcomes. Regardless of age at time of transplant, AYA transplant recipients have a higher risk of graft loss compared to other age groups. A transition from pediatric to adult healthcare teams often occurs during this life period, potentially intensifying this challenging time. Recently the COVID-19 pandemic has compounded anxiety and stressors surrounding major life events, adding uncertainty and lack of normalcy for this population. Methods: In 2016, our center implemented a comprehensive, multidisciplinary Transition-to-Adult-Care (T2AC) curriculum for AYA SOT recipients to facilitate successful transfer of care. This curriculum consists of longitudinal education, readiness assessment, outreach programming, and a day-long seminar focusing on education from pediatric and adult transplant providers, pharmacists, coordinators, social workers, and psychologists. “Graduates” of our curriculum demonstrate improved transplant outcomes in the first year following transition with decreased rejection episodes, De novo DSA formation, graft loss, loss to follow-up, ED visits and inpatient admissions, and fewer “bounce-backs” to the pediatric center [Abstract C221;Am J Transplant. 2019;19 (suppl 3)]. Recognizing the need to continue preparing our AYA population for transition, despite limitations created by social distancing, we adapted the T2AC Transitions Seminar to a virtual platform. Patients and caregivers received virtual didactic education with visual aids, interacted with providers and peers, and received support from transplant psychology during focused break-out sessions. Results: Despite changes in structure and platform, virtual programming was successfully implemented. This event boasted the highest attendance to date with 25 AYA recipients and additional family members participating;we hypothesize this was attributed to joining from a location of their choosing, precluding the need for travel. Additionally, active participation was notably increased, potentially related to multiple modes of online interaction (e.g. private/group chat message) and minimized anxiety by removing in-person interaction. A post-course survey indicated positive reception with an average response of 7.7 /10 (10 = Very Likely) to “How likely are you to attend a similar event again in the future?”. The average response to “After attending this event, how prepared do you feel for transitioning to adult care?” of 6.7/10, comparable to 7.2 for prior in-person events, suggests change in venue did not reduce impact. Conclusions: Given the overall positive experience, we plan to maintain and grow the virtual nature of our T2AC Seminar through the pandemic and beyond, hoping to broaden our audience and strengthen our educational mission.