title: Heightened graft failure risk during emerging adulthood and transition to adult care.
abstract: Emerging adulthood, defined as the interval between 18 and 25 years of age, is a socially-defined developmental stage. Although people in this age group appear physically mature, brain maturation is not complete until the end of this period. Perhaps due to this immaturity and a resulting inferior ability to manage chronic illness emerging adults with a variety of chronic health conditions are at a high risk for adverse outcomes. In this review I will summarize evidence that emerging adulthood constitutes a high-risk period for kidney transplant recipients, and consider the possible reasons for the spike in graft failure risk during this age interval-including age-related adherence behaviour and the changes in care organization, processes and structures associated with transfer from pediatric to adult-oriented care. I will also discuss evidence showing transfer from pediatric to adult-oriented care contributes to this elevated risk, and highlight the limitations and challenges of studies examining this question. Finally, I will direct readers to resources providing guidance on the best practices for care of patients transitioning to adult care.
authors.affiliation: Montreal Children's Hospital, Research Institute of the McGill University Health Centre; Department of Pediatrics, Division of Nephrology and Department of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, 2300 Tupper St., E-222, Montreal, Quebec, H3H 1P3, Canada, bethany.foster@mcgill.ca.
authors.forename: Bethany J
authors.initials: BJ
authors.lastname: Foster
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D006084:Graft Rejection / Q000209:etiology*; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D012306:Risk; D055815:Young Adult