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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Wolters Kluwer Health
2015
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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. |
format | Online Article Text |
id | pubmed-4674210 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
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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