Details
| Original language | English |
|---|---|
| Pages (from-to) | 518-524 |
| Number of pages | 7 |
| Journal | Pediatric Transplantation |
| Volume | 17 |
| Issue number | 6 |
| Early online date | 4 Jun 2013 |
| Publication status | Published - Sept 2013 |
| Externally published | Yes |
Abstract
Transition from pediatric to adult care is a critical and difficult step for young people with transplants and for the multidisciplinary team involved. In our retrospective study, we investigated the clinical course in a two-yr period of transition. Data from 66 teenagers were collected one yr before and after their transfer to three different adult care settings: (i) a specialized transition clinic, (ii) a general transplantation clinic, and (iii) a nephrologist. Patient survival rate was 100%. Three patients developed graft loss. GFR development was comparable in the three settings (ΔGFR 1.4 ± 8.7 vs. 3.1 ± 10.6 vs. 0.8 ± 4.4 mL/min/1.73 m 2, p = ns). Immunosuppressive therapy was stable in setting 1, whereas the number of changes increased in setting 2 and even more in setting 3. The percentage of patients with steroids increased from 36% to 38% and 52% in settings 1-3. Patient satisfaction was highest in setting 1 (100% vs. 64% and 78%, p < 0.05). Setting 1 was associated with fewer changes in therapy (13% vs. 91% and 45%, p < 0.05). The use of a specialized transition clinic is associated with fewer changes in medication and care and a higher level of patient satisfaction. This was not associated with a lower increase in GFR one yr after transition. Long-term results are awaited.
Keywords
- glomerular filtration rate, pediatric kidney transplantation, transition
ASJC Scopus subject areas
- Medicine(all)
- Pediatrics, Perinatology, and Child Health
- Medicine(all)
- Transplantation
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In: Pediatric Transplantation, Vol. 17, No. 6, 09.2013, p. 518-524.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Different models of transition to adult care after pediatric kidney transplantation
T2 - A comparative study
AU - Pape, L.
AU - Lämmermühle, J.
AU - Oldhafer, M.
AU - Blume, Cornelia
AU - Weiss, R.
AU - Ahlenstiel, T.
PY - 2013/9
Y1 - 2013/9
N2 - Transition from pediatric to adult care is a critical and difficult step for young people with transplants and for the multidisciplinary team involved. In our retrospective study, we investigated the clinical course in a two-yr period of transition. Data from 66 teenagers were collected one yr before and after their transfer to three different adult care settings: (i) a specialized transition clinic, (ii) a general transplantation clinic, and (iii) a nephrologist. Patient survival rate was 100%. Three patients developed graft loss. GFR development was comparable in the three settings (ΔGFR 1.4 ± 8.7 vs. 3.1 ± 10.6 vs. 0.8 ± 4.4 mL/min/1.73 m 2, p = ns). Immunosuppressive therapy was stable in setting 1, whereas the number of changes increased in setting 2 and even more in setting 3. The percentage of patients with steroids increased from 36% to 38% and 52% in settings 1-3. Patient satisfaction was highest in setting 1 (100% vs. 64% and 78%, p < 0.05). Setting 1 was associated with fewer changes in therapy (13% vs. 91% and 45%, p < 0.05). The use of a specialized transition clinic is associated with fewer changes in medication and care and a higher level of patient satisfaction. This was not associated with a lower increase in GFR one yr after transition. Long-term results are awaited.
AB - Transition from pediatric to adult care is a critical and difficult step for young people with transplants and for the multidisciplinary team involved. In our retrospective study, we investigated the clinical course in a two-yr period of transition. Data from 66 teenagers were collected one yr before and after their transfer to three different adult care settings: (i) a specialized transition clinic, (ii) a general transplantation clinic, and (iii) a nephrologist. Patient survival rate was 100%. Three patients developed graft loss. GFR development was comparable in the three settings (ΔGFR 1.4 ± 8.7 vs. 3.1 ± 10.6 vs. 0.8 ± 4.4 mL/min/1.73 m 2, p = ns). Immunosuppressive therapy was stable in setting 1, whereas the number of changes increased in setting 2 and even more in setting 3. The percentage of patients with steroids increased from 36% to 38% and 52% in settings 1-3. Patient satisfaction was highest in setting 1 (100% vs. 64% and 78%, p < 0.05). Setting 1 was associated with fewer changes in therapy (13% vs. 91% and 45%, p < 0.05). The use of a specialized transition clinic is associated with fewer changes in medication and care and a higher level of patient satisfaction. This was not associated with a lower increase in GFR one yr after transition. Long-term results are awaited.
KW - glomerular filtration rate
KW - pediatric kidney transplantation
KW - transition
UR - http://www.scopus.com/inward/record.url?scp=84881140196&partnerID=8YFLogxK
U2 - 10.1111/petr.12102
DO - 10.1111/petr.12102
M3 - Article
AN - SCOPUS:84881140196
VL - 17
SP - 518
EP - 524
JO - Pediatric Transplantation
JF - Pediatric Transplantation
SN - 1397-3142
IS - 6
ER -