Standardized multilevel transition program: Does it affect renal transplant outcome?

Pediatr Transplant. 2015 Nov;19(7):691-7. doi: 10.1111/petr.12570. Epub 2015 Aug 11.

Abstract

The transfer of renal transplant patients from pediatric to adult care is a crucial step with a high risk of subsequent graft loss. Therefore, the transition should be a thoroughly planned, well-designed and multidisciplinary process focused on the individual patient. Our pediatric nephrology department introduced a structured step-by-step transition program supported by a multidisciplinary team of health professionals. The purpose of our study was to determine the effects of the transition program on eGFR and number of ARs in comparison to a group without a transition program at one and three yr after transfer. We conducted a single-center retrospective cohort study of renal transplant patients prior to and after the introduction of the transition program. Multiple regression analysis revealed a significantly lower decline of eGFR in the group with transition program (-11.3 ± 44 mL/min/1.73 m(2) ) compared to the group without transition program (-28.4 ± 33 mL/min/1.73 m(2) ) at three yr after transfer. The number of AR episodes significantly decreased from 34.6% in the group without transition program to 9.1% in the group with transition program. The standardized multilevel transition program seems to have significant positive effects on eGFR and number of AR episodes in renal transplant patients.

Keywords: acute rejection; adherence; glomerular filtration rate; non-adherence; transfer; transition.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Glomerular Filtration Rate*
  • Graft Rejection / prevention & control*
  • Humans
  • Kidney Transplantation*
  • Male
  • Outcome and Process Assessment, Health Care
  • Postoperative Care / methods*
  • Regression Analysis
  • Retrospective Studies
  • Transition to Adult Care / organization & administration*
  • Young Adult