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Cited by 48Adolescent and Pediatric HealthcareRenal Transplantation Outcomes and TreatmentsOrgan and Tissue Transplantation Research

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

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Kreuzer, Martin, Prüfe, Jenny, Oldhafer, Martina, Bethe, Dirk, Dierks, Marie-Luise, Müther, Silvia, Thumfart, Julia, Hoppe, Bernd +22 more·2015·Medicine
DOI 10.1097/md.0000000000002196PMC PMC4674210
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Abstract

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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  • High variability of immunosuppressant blood levels was associated with unfavorable allograft outcome in solid organ transplant recipients, including patients after lung transplantation.

    “High variability was associated with unfavorable allograft outcome in solid organ transplant recipients, including patients after lung transplantation[10,37–39].”

    From Adherence is associated with a favorable outcome after lung transplantation (2019) · cites this paper as [38]

    The Discussion (Graft Function and Medication Adherence in Transition; page not provided) reports that previous studies linked high tacrolimus blood-level variability to late rejection and graft failure in children with kidney and other solid-organ transplants. It does not identify lung transplant recipients, and the authors found no statistically significant predictive value for rejection or graft loss in their own kidney-transplant cohort. (LLM, conf=0.88)

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Research works printed but not linked: 29

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Authors
Kreuzer, M., Prüfe, J., Oldhafer, M., Bethe, D., Dierks, M.-L., Müther, S., Thumfart, J., Hoppe, B., Büscher, A., Rascher, W., Hansen, M., Pohl, M., Kemper, M. J., Drube, J., Rieger, S., John, U., Taylan, C., Dittrich, K., Hollenbach, S., Klaus, G., Fehrenbach, H., Kranz, B., Montoya, C., Lange-Sperandio, B., Ruckenbrodt, B., Billing, H., Staude, H., Heindl-Rusai, K., Brunkhorst, R., & Pape, L.
Affiliations
  • University of Bonn (DE)
  • Heidelberg University (DE)
Corresponding author
Kreuzer, Martin
ORCID
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-12
Volume
94
Issue
48
Pages
e2196
ISSN
0025-7974 (ISSN-L)
DOI
10.1097/md.0000000000002196
PMC
PMC4674210
OpenAlex
W2184777820
Cited by
48
References
1
Citations by year
2026: 4 · 2025: 5 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 6 · 2020: 3 · 2019: 8 · 2018: 10 · 2017: 4
FWCI
10.23
Type
journal article
Language
en
Open access
Licence
cc-by-nd
Locations
  • Medicine (publishedVersion, cc-by-nd)
  • PubMed Central (publishedVersion, cc-by-nd)
  • PubMed (publishedVersion)
  • Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
Funders
KfH-Stiftung Präventivmedizin
Topics
  • Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
  • Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
  • Health Sciences › Medicine › Transplantation › Organ and Tissue Transplantation Research
Keywords
kidney transplantation, transition from pediatric to adult care, adolescents and young adults, immunosuppression adherence, graft rejection, graft failure, serum creatinine
MeSH terms
Assessment of Medication Adherence, Adolescent, Adult, Austria, Female, Germany, Graft Rejection, Humans, Immunosuppressive Agents, Male, Retrospective Studies, Kidney Transplantation, Drug Monitoring, Medication Adherence, Young Adult, Transition to Adult Care

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