Transition is a process; transfer is one event
Children with rare disease often rely on pediatric teams that know the family and condition deeply. Adult services may be organized differently and may have less experience with childhood-onset disorders.
A planned transition builds self-management skills, updates consent and decision-making, identifies adult specialists and transfers a concise medical summary before the final pediatric visit.
Medication authorization, infusion access, devices, supplies and emergency contacts should be confirmed before pediatric eligibility ends.
Who may be considered?
This review may help when the phenotype and existing evidence create a focused question about a safe transition from pediatric to adult care.
- An adolescent with a lifelong rare disorder.
- A young adult still dependent on pediatric systems.
- A family facing changes in consent or legal decision-making.
- A patient moving country, school, work or insurance system.
- A complex case needing adult organ specialists and primary care.
What the specialist team must confirm
The team reviews health literacy, communication, cognitive and legal needs, medication management, emergency knowledge, reproductive counselling, mental health, education, work, benefits, equipment and the readiness of adult services.
Key points for this treatment

From family-led pediatric care to supported adult care
Responsibility shifts gradually while safeguards remain for cognition, communication and system barriers.
Adult-life priorities and long-term continuity
Adult care adds reproductive health, mental health, education, work, independent living and long-term complication surveillance. Privacy and family involvement are discussed explicitly.
After transfer, both teams should verify that appointments occurred, prescriptions continued and urgent contacts are understood. A failed handoff is corrected quickly.

Limits, burdens and realistic expectations
Adult expertise may be scarce, eligibility and insurance rules can change, and independence expectations may not fit cognitive or physical needs. Poor transition increases missed care and treatment interruption.
Any threatened interruption of life-sustaining medicine, ventilation, nutrition or emergency access requires prompt coordination with the current and receiving teams.
