A review of all paediatric liver transplant recipients who have transitioned into adult care at the Sir Charles Gairdner Hospital in WA has shown outcomes exceed those published in the international literature.

The study, the first of its kind in Australia, found a 1-year survival rate of 100% and 5-year survival of 92% with no episodes of late rejection.

About two-thirds of patients were compliant with immunosuppression (67%) and clinic attendance (61%).

Importantly, the psychosocial outcomes for the cohort of 18 young people reflected their peers in the general population.

Hepatology registrar Dr Tim Mitchell told the limbic the patients were all fully engaged studying at university, in training such as apprenticeships or working.

Their drug and alcohol use was also consistent with young people in the general population.

“This is why we transplant children – so they can go on to lead relatively normal lives,” Dr Mitchell said.

He said the small size of the transplant unit in WA was likely to be a positive factor in the successful transitions.

“As is true of all other states, our expertise and interest is focused in a single centre unit. But the nature of a small unit lends itself to continuity of care. There is extra communication between team members and it is easier to detect and intervene effectively in issues such as poor patient compliance.”

The study found patients with the widest variation in tacrolimus levels before transition were less likely to be compliant after transition.

“It makes sense intuitively that if they haven’t been on top of their immunosuppression before transition then they are more likely to have problems afterwards,” he said.

Dr Mitchell said while the unit was small, transplant nurses effectively played the role of default transplant coordinators.

Other practices to smooth the transition period included paediatric nurses accompanying patients to their first visit at the adult hospital, early clinic appointments so young people weren’t waiting around and patients allocated to just one consultant for their first 12 months.