J.Jpn. Surg. Soc.. 126(4): 326-333, 2025

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Feature topic

TRANSITIONAL CARE FOR HEPATOBILIARY DISEASES

Recent improvements in treatment in pediatrics and pediatric surgery have increased the number of patients who require medical support until adulthood. Therefore, it is necessary to develop an appropriate system for transitional care for young adults with special health care needs (YASHCN). Regarding biliary atresia, advances in Kasai portoenterostomy and liver transplantation have improved survival rates. However, some native liver survivors with biliary atresia have sequelae, such as cholangitis and jaundice recurrence in adulthood. As support for transitional care for YASHCN, pediatric surgeons coordinate treatment strategy, and adult medical providers provide treatment in their specific fields. The key factors to promoting transitional care are supporting self-sufficient living, medical care based on interdisciplinary cooperation, and standardization for medical management in adulthood.
Lacking scientific evidence for rare diseases, it is often difficult to standardize treatment. Recently, academic societies and research groups have been working to develop documents that serve as guides to adult-oriented medical care for each disease. They develop disease-specific clinical practice guidelines and share information with the adult medical carers. In the future, promoting the sharing of the importance of transitional care and developing suitable transitional care systems are necessary.

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