Different models of transition to adult care after pediatric kidney transplantation: A comparative study

• Published in: Pediatric transplantation 2013-09, Vol.17 (6), p.518-524
• Main Authors: Pape, L., Lämmermühle, J., Oldhafer, M., Blume, C., Weiss, R., Ahlenstiel, T.
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Cohort Studies; Cyclosporine - therapeutic use; Female; Glomerular Filtration Rate; Graft Rejection; Graft Survival; Humans; Immunosuppressive Agents - therapeutic use; Kidney Transplantation - methods; Male; Mycophenolic Acid - therapeutic use; pediatric kidney transplantation; Renal Insufficiency - therapy; Retrospective Studies; Steroids - therapeutic use; Surveys and Questionnaires; transition; Transition to Adult Care
• ISSN: 1397-3142; 1399-3046
• DOI: 10.1111/petr.12102

Transition from pediatric to adult care is a critical and difficult step for young people with transplants and for the multidisciplinary team involved. In our retrospective study, we investigated the clinical course in a two‐yr period of transition. Data from 66 teenagers were collected one yr before and after their transfer to three different adult care settings: (i) a specialized transition clinic, (ii) a general transplantation clinic, and (iii) a nephrologist. Patient survival rate was 100%. Three patients developed graft loss. GFR development was comparable in the three settings (ΔGFR 1.4 ± 8.7 vs. 3.1 ± 10.6 vs. 0.8 ± 4.4 mL/min/1.73 m2, p = ns). Immunosuppressive therapy was stable in setting 1, whereas the number of changes increased in setting 2 and even more in setting 3. The percentage of patients with steroids increased from 36% to 38% and 52% in settings 1–3. Patient satisfaction was highest in setting 1 (100% vs. 64% and 78%, p