The 'Cross-Trust' Histopathology Multidisciplinary Team: Report of meeting outputs and impact on paediatric inflammatory bowel disease management in a UK tertiary centre.

Abstract

Objectives: To evaluate the outputs and clinical impact of a Cross-Trust Histopathology Multidisciplinary Team (MDT) created to support diagnostic clarification and management of complex paediatric inflammatory bowel disease (IBD) cases, particularly during transition to adult services.

Methods: A retrospective review of eight MDT meetings held from January 2021 to March 2024 was performed. Patients were included if referred for diagnostic uncertainty, complex disease behaviour or transition planning. Extracted data included demographics, reason for referral, MDT-agreed diagnosis, therapeutic recommendations and transition-related decisions.

Results: Twenty-seven patients (mean age 17.2 years; range: 14-21) were discussed. Diagnostic clarification was the primary referral reason. Following MDT review, 11 patients (41%) had a change in diagnosis, including reclassification of IBD-unclassified to ulcerative colitis (n = 7) or Crohn's disease (n = 3). One patient was reclassified as having non-IBD (disuse colitis). Management recommendations changed in three patients (11%), including biologic initiation or escalation. One patient (4%) had a modification to their transition pathway. MDT outputs were uploaded into the paediatric electronic health record in only three cases (11%).

Conclusion: The Cross-Trust Histopathology MDT improved diagnostic precision in complex paediatric IBD and influenced management in selected cases. The model supports harmonized interpretation across paediatric and adult services and promotes safer transition planning. Documentation of MDT outcomes remains an area for improvement. Wider adoption of similar collaborative frameworks may enhance diagnostic consistency and optimize care for adolescents with IBD.