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Pediatric Renal Transplantation: Focus on Current Transition Care and Proposal of the “RISE to Transition” Protocol

The transition from pediatric to adult medical services is an important time in the life of an adolescent or young adult with a renal transplant. Failure of proper transition can lead to medical non-adherence and subsequent loss of graft and/or return to dialysis. The aim of this study was to conduc...

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Autores principales: Raina, Rupesh, Wang, Joseph, Krishnappa, Vinod, Ferris, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248065/
https://www.ncbi.nlm.nih.gov/pubmed/29335397
http://dx.doi.org/10.12659/AOT.906279
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author Raina, Rupesh
Wang, Joseph
Krishnappa, Vinod
Ferris, Maria
author_facet Raina, Rupesh
Wang, Joseph
Krishnappa, Vinod
Ferris, Maria
author_sort Raina, Rupesh
collection PubMed
description The transition from pediatric to adult medical services is an important time in the life of an adolescent or young adult with a renal transplant. Failure of proper transition can lead to medical non-adherence and subsequent loss of graft and/or return to dialysis. The aim of this study was to conduct a systematic review and survey to assess the challenges and existing practices in transition of renal transplant recipient children to adult services, and to develop a transition protocol. We conducted a literature review and performed a survey of pediatric nephrologists across the United States to examine the current state of transition care. A structured transition protocol was developed based on these results. Our literature review revealed that a transition program has a positive impact on decline in renal function and acute rejection episodes, and may improve long-term graft outcomes in pediatric kidney transplant patients. With a response rate of 40% (60/150) from nephrologists in 56% (49/87) of centers, our survey shows inconsistent use of validated tools despite their availability, inefficient communication between teams, and lack of use of dedicated clinics. To address these issues, we developed the “RISE to Transition” protocol, which relies on 4 competency areas: Recognition, Insight, Self-reliance, and Establishment of healthy habits. The transition program decreases acute graft rejection episodes, and the main challenges in transition care are the communication gap between health care providers and inconsistent use of transition tools. Our RISE to transition protocol incorporates transition tools, defines personnel, and aims to improve communication between teams.
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spelling pubmed-62480652018-11-28 Pediatric Renal Transplantation: Focus on Current Transition Care and Proposal of the “RISE to Transition” Protocol Raina, Rupesh Wang, Joseph Krishnappa, Vinod Ferris, Maria Ann Transplant Review Paper The transition from pediatric to adult medical services is an important time in the life of an adolescent or young adult with a renal transplant. Failure of proper transition can lead to medical non-adherence and subsequent loss of graft and/or return to dialysis. The aim of this study was to conduct a systematic review and survey to assess the challenges and existing practices in transition of renal transplant recipient children to adult services, and to develop a transition protocol. We conducted a literature review and performed a survey of pediatric nephrologists across the United States to examine the current state of transition care. A structured transition protocol was developed based on these results. Our literature review revealed that a transition program has a positive impact on decline in renal function and acute rejection episodes, and may improve long-term graft outcomes in pediatric kidney transplant patients. With a response rate of 40% (60/150) from nephrologists in 56% (49/87) of centers, our survey shows inconsistent use of validated tools despite their availability, inefficient communication between teams, and lack of use of dedicated clinics. To address these issues, we developed the “RISE to Transition” protocol, which relies on 4 competency areas: Recognition, Insight, Self-reliance, and Establishment of healthy habits. The transition program decreases acute graft rejection episodes, and the main challenges in transition care are the communication gap between health care providers and inconsistent use of transition tools. Our RISE to transition protocol incorporates transition tools, defines personnel, and aims to improve communication between teams. International Scientific Literature, Inc. 2018-01-16 /pmc/articles/PMC6248065/ /pubmed/29335397 http://dx.doi.org/10.12659/AOT.906279 Text en © Ann Transplant, 2018 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Review Paper
Raina, Rupesh
Wang, Joseph
Krishnappa, Vinod
Ferris, Maria
Pediatric Renal Transplantation: Focus on Current Transition Care and Proposal of the “RISE to Transition” Protocol
title Pediatric Renal Transplantation: Focus on Current Transition Care and Proposal of the “RISE to Transition” Protocol
title_full Pediatric Renal Transplantation: Focus on Current Transition Care and Proposal of the “RISE to Transition” Protocol
title_fullStr Pediatric Renal Transplantation: Focus on Current Transition Care and Proposal of the “RISE to Transition” Protocol
title_full_unstemmed Pediatric Renal Transplantation: Focus on Current Transition Care and Proposal of the “RISE to Transition” Protocol
title_short Pediatric Renal Transplantation: Focus on Current Transition Care and Proposal of the “RISE to Transition” Protocol
title_sort pediatric renal transplantation: focus on current transition care and proposal of the “rise to transition” protocol
topic Review Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248065/
https://www.ncbi.nlm.nih.gov/pubmed/29335397
http://dx.doi.org/10.12659/AOT.906279
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