Title : Are we ready for building transition programs for heart transplant recipients in Japan? Knowing the unique background is the first step for discussion
Although Japan is one of the most developed countries from an economic, educational, and even medical viewpoint, several specific areas in medicine have straggled far behind the US or European countries. Such specific areas included transplant medicine and the transition of patients with childhood-onset chronic diseases from pediatric to adult healthcare systems. Especially, the transition medicine specific to heart transplantation (HTx) has never been fully discussed in Japan to date.
Indeed, thanks to the recent advances in post-transplant care including immunosuppressive management, more and more pediatric organ recipients are surviving to adolescence and adulthood. The transition from pediatric to adult care is a crucial period with a risk of non-adherence and poor outcomes for organ transplant recipients. One of the goals of transition is self-management of immunosuppressants and infection prophylaxis; however, non-medical issues such as marriage and family planning should be also carefully discussed depending on their primary diseases or medications.
In addition to the donated organs’ care, transplant teams also need to pay attention to the recipients’ spiritual growth and conflicted feelings. While waiting for transplant surgery, they are unable to interact with healthy peers of the same age. Instead of interaction with their peers, they not only struggle with the end-stage illness but also need to spend an uncertainly lasting long period with a thought of their own and possible donors’ deaths. Such unusual circumstances sometimes hinder them from developing mental or emotional growth.Therefore, the transition should be performed through a multidisciplinary process by multidisciplinary medical professionals.
This presentation highlight the underlying issues surrounding both HTx and transition medicine in Japan to initiate constructive discussion.