Not a Child, Not Yet an Adult: Transition Experiences in Pediatric Transplant Recipients.

Abstract

Objectives: The transition from pediatric to adult health care services is a critical milestone for adolescents who have undergone solid -organ transplant. Despite medical advances, this period remains a vulnerable one due to changes in care structures, patient autonomy, and psychosocial challenges. Qualitative evidence exploring this transition experience is limited in the context of Turkish health care. In this study, we examined the lived experiences, perceptions, and expectations of adolescents and young adults who underwent pediatric kidney or liver transplant in Türkiye, with a specific focus on their transition to adult health care services.

Materials and methods: A descriptive phenomenological design was employed. We conducted semi -structured interviews with 11 participants aged 16 years and older who had received a kidney or liver transplant during childhood. We collected data via telephone interviews, which were audio -recorded with informed consent. We conducted thematic analysis to identify core themes reflecting the participants' transition experiences.

Results: Four major themes emerged from the analysis: (1 ) anticipation and anxiety of change (fear of leaving familiar pediatric care teams ); (2 ) need for information and guidance (lack of structured transition education); (3 ) emotional ambivalence (feelings of independence mixed with insecurity ); and (4 ) health care system barriers (perceived fragmentation and lack of continuity in adult care settings ). Participants expressed a strong desire for more personalized, supported, and phased transition models.

Conclusions: The transition to adult care in pediatric solid -organ transplant recipients presents emotional, informational, and systemic challenges. Structured, culturally sensitive transition programs are urgently needed in Türkiye to optimize continuity of care and health outcomes.