Liver Transplant Program Transition to Adult Healthcare Guidelines

The Liver Transplant Program at Children’s Hospital of Philadelphia (CHOP) is committed to helping our patients make a smooth transition from pediatric to adult healthcare. This process involves working together with our patients and their families.

Starting at age 12

Starting as early as when the patient is 12 years old, we begin preparing patients for the change from pediatric to adult care. In the adult setting, patients increase their role in decision-making and take responsibility for their healthcare, and the parents are not as directly involved. This means that we will spend time during our annual visits with patients ages 12+. Our goals are to:

Promote patient understanding of their medical history
Set priorities for healthcare management
Support them in becoming more independent with their own healthcare

At clinic visits, starting at age 12, our patients will meet with different providers to:

Review their physical and emotional health
Discuss strategies to promote well-being and adherence
Learn tips on how to manage and advocate for their own healthcare with the goal of developing life skills in anticipation of eventually transitioning to an adult liver transplant team

This discussion takes place as part of routine clinic visits and may include meetings with a transplant psychologist, social worker and/or pharmacist, in addition to the hepatologist (liver doctor) and nurse practitioner.

At age 18

In the United States, youths become legal adults at age 18. We respect that many of our young adult patients choose to continue to involve their families in healthcare decisions. Family support is important at every age. Once a patient turns 18, we need their written consent to discuss their health information with family members. If the patient has a condition that limits their ability to make their own healthcare decisions due to a developmental or intellectual disability, we encourage parents/caregivers to discuss this with the liver transplant team’s social worker, who can provide resources for learning about options for supported decision-making.

By age 22

We collaborate with our patients and families to determine the best timing for transferring to an adult healthcare provider; however, transfer of care to an adult liver transplant team is expected to occur by age 22 or earlier. We will assist with this transfer process, including helping to identify an adult provider, sending medical records, and communicating with the adult provider about the unique needs of our patients.