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Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria: A Binational Observatory Census Within the TRANSNephro Trial

Transition from child to adult-oriented care is widely regarded a challenging period for young people with kidney transplants and is associated with a high risk of graft failure. We analyzed the existing transition structures in Germany and Austria using a questionnaire and retrospective data of 119...

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Autores principales: Kreuzer, Martin, Prüfe, Jenny, Oldhafer, Martina, Bethe, Dirk, Dierks, Marie-Luise, Müther, Silvia, Thumfart, Julia, Hoppe, Bernd, Büscher, Anja, Rascher, Wolfgang, Hansen, Matthias, Pohl, Martin, Kemper, Markus J., Drube, Jens, Rieger, Susanne, John, Ulrike, Taylan, Christina, Dittrich, Katalin, Hollenbach, Sabine, Klaus, Günter, Fehrenbach, Henry, Kranz, Birgitta, Montoya, Carmen, Lange-Sperandio, Bärbel, Ruckenbrodt, Bettina, Billing, Heiko, Staude, Hagen, Heindl-Rusai, Krisztina, Brunkhorst, Reinhard, Pape, Lars
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4674210/
https://www.ncbi.nlm.nih.gov/pubmed/26632907
http://dx.doi.org/10.1097/MD.0000000000002196
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author Kreuzer, Martin
Prüfe, Jenny
Oldhafer, Martina
Bethe, Dirk
Dierks, Marie-Luise
Müther, Silvia
Thumfart, Julia
Hoppe, Bernd
Büscher, Anja
Rascher, Wolfgang
Hansen, Matthias
Pohl, Martin
Kemper, Markus J.
Drube, Jens
Rieger, Susanne
John, Ulrike
Taylan, Christina
Dittrich, Katalin
Hollenbach, Sabine
Klaus, Günter
Fehrenbach, Henry
Kranz, Birgitta
Montoya, Carmen
Lange-Sperandio, Bärbel
Ruckenbrodt, Bettina
Billing, Heiko
Staude, Hagen
Heindl-Rusai, Krisztina
Brunkhorst, Reinhard
Pape, Lars
author_facet Kreuzer, Martin
Prüfe, Jenny
Oldhafer, Martina
Bethe, Dirk
Dierks, Marie-Luise
Müther, Silvia
Thumfart, Julia
Hoppe, Bernd
Büscher, Anja
Rascher, Wolfgang
Hansen, Matthias
Pohl, Martin
Kemper, Markus J.
Drube, Jens
Rieger, Susanne
John, Ulrike
Taylan, Christina
Dittrich, Katalin
Hollenbach, Sabine
Klaus, Günter
Fehrenbach, Henry
Kranz, Birgitta
Montoya, Carmen
Lange-Sperandio, Bärbel
Ruckenbrodt, Bettina
Billing, Heiko
Staude, Hagen
Heindl-Rusai, Krisztina
Brunkhorst, Reinhard
Pape, Lars
author_sort Kreuzer, Martin
collection PubMed
description Transition from child to adult-oriented care is widely regarded a challenging period for young people with kidney transplants and is associated with a high risk of graft failure. We analyzed the existing transition structures in Germany and Austria using a questionnaire and retrospective data of 119 patients transferred in 2011 to 2012. Most centers (73%) confirmed agreements on the transition procedure. Patients’ age at transfer was subject to regulation in 73% (18 years). Median age at transition was 18.3 years (16.5–36.7). Median serum creatinine increased from 123 to 132 μmol/L over the 12 month observation period before transfer (P = 0.002). A total of 25/119 patients showed increased creatinine ≥20% just before transfer. Biopsy proven rejection was found in 10/119 patients. Three patients lost their graft due to chronic graft nephropathy. Mean coefficient of variation (CoV%) of immunosuppression levels was 0.20 ± 0.1. Increased creatinine levels ≥20% just before transfer were less frequently seen in patients with CoV < 0.20 (P = 0.007). The majority of pediatric nephrology centers have internal agreements on transitional care. More than half of the patients had CoV of immunosuppression trough levels consistent with good adherence. Although, 20% of the patients showed increase in serum creatinine close to transfer.
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spelling pubmed-46742102015-12-14 Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria: A Binational Observatory Census Within the TRANSNephro Trial Kreuzer, Martin Prüfe, Jenny Oldhafer, Martina Bethe, Dirk Dierks, Marie-Luise Müther, Silvia Thumfart, Julia Hoppe, Bernd Büscher, Anja Rascher, Wolfgang Hansen, Matthias Pohl, Martin Kemper, Markus J. Drube, Jens Rieger, Susanne John, Ulrike Taylan, Christina Dittrich, Katalin Hollenbach, Sabine Klaus, Günter Fehrenbach, Henry Kranz, Birgitta Montoya, Carmen Lange-Sperandio, Bärbel Ruckenbrodt, Bettina Billing, Heiko Staude, Hagen Heindl-Rusai, Krisztina Brunkhorst, Reinhard Pape, Lars Medicine (Baltimore) 4000 Transition from child to adult-oriented care is widely regarded a challenging period for young people with kidney transplants and is associated with a high risk of graft failure. We analyzed the existing transition structures in Germany and Austria using a questionnaire and retrospective data of 119 patients transferred in 2011 to 2012. Most centers (73%) confirmed agreements on the transition procedure. Patients’ age at transfer was subject to regulation in 73% (18 years). Median age at transition was 18.3 years (16.5–36.7). Median serum creatinine increased from 123 to 132 μmol/L over the 12 month observation period before transfer (P = 0.002). A total of 25/119 patients showed increased creatinine ≥20% just before transfer. Biopsy proven rejection was found in 10/119 patients. Three patients lost their graft due to chronic graft nephropathy. Mean coefficient of variation (CoV%) of immunosuppression levels was 0.20 ± 0.1. Increased creatinine levels ≥20% just before transfer were less frequently seen in patients with CoV < 0.20 (P = 0.007). The majority of pediatric nephrology centers have internal agreements on transitional care. More than half of the patients had CoV of immunosuppression trough levels consistent with good adherence. Although, 20% of the patients showed increase in serum creatinine close to transfer. Wolters Kluwer Health 2015-12-07 /pmc/articles/PMC4674210/ /pubmed/26632907 http://dx.doi.org/10.1097/MD.0000000000002196 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 4000
Kreuzer, Martin
Prüfe, Jenny
Oldhafer, Martina
Bethe, Dirk
Dierks, Marie-Luise
Müther, Silvia
Thumfart, Julia
Hoppe, Bernd
Büscher, Anja
Rascher, Wolfgang
Hansen, Matthias
Pohl, Martin
Kemper, Markus J.
Drube, Jens
Rieger, Susanne
John, Ulrike
Taylan, Christina
Dittrich, Katalin
Hollenbach, Sabine
Klaus, Günter
Fehrenbach, Henry
Kranz, Birgitta
Montoya, Carmen
Lange-Sperandio, Bärbel
Ruckenbrodt, Bettina
Billing, Heiko
Staude, Hagen
Heindl-Rusai, Krisztina
Brunkhorst, Reinhard
Pape, Lars
Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria: A Binational Observatory Census Within the TRANSNephro Trial
title Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria: A Binational Observatory Census Within the TRANSNephro Trial
title_full Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria: A Binational Observatory Census Within the TRANSNephro Trial
title_fullStr Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria: A Binational Observatory Census Within the TRANSNephro Trial
title_full_unstemmed Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria: A Binational Observatory Census Within the TRANSNephro Trial
title_short Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria: A Binational Observatory Census Within the TRANSNephro Trial
title_sort transitional care and adherence of adolescents and young adults after kidney transplantation in germany and austria: a binational observatory census within the transnephro trial
topic 4000
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4674210/
https://www.ncbi.nlm.nih.gov/pubmed/26632907
http://dx.doi.org/10.1097/MD.0000000000002196
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