title: Standardized multilevel transition program: Does it affect renal transplant outcome?
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.
authors.affiliation: Nephrology Unit, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Marcus
authors.initials: M
authors.lastname: Weitz
authors.affiliation: Department of Nephrology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Saskia
authors.initials: S
authors.lastname: Heeringa
authors.affiliation: Children's Hospital Lucerne, Lucerne, Switzerland.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Neuhaus
authors.affiliation: Department of Nephrology, University Hospital Zurich, Zurich, Switzerland.|Department of Internal Medicine, Cantonal Hospital Graubuenden, Chur, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fehr
authors.affiliation: Nephrology Unit, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Guido F
authors.initials: GF
authors.lastname: Laube
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011182:Postoperative Care / Q000379:methods*; D012044:Regression Analysis; D012189:Retrospective Studies; D060305:Transition to Adult Care / Q000458:organization & administration*; D055815:Young Adult
keywords: acute rejection; adherence; glomerular filtration rate; non-adherence; transfer; transition