16 January 2018 : Review article
Pediatric Renal Transplantation: Focus on Current Transition Care and Proposal of the “RISE to Transition” ProtocolRupesh Raina1ABCDEF*, Joseph Wang2ABCDEF, Vinod Krishnappa3ABCDEF, Maria Ferris4ABCDEF
Ann Transplant 2018; 23:45-60
ABSTRACT: 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.
Keywords: Health Transition, Kidney Transplantation, medication adherence, Transition to Adult Care
11 Jan 2022 : Original articleEfficacy of Nitric Oxide-Releasing Nanofibers in Reducing Renal Ischemia-Reperfusion Injury in a Rat Model
Ann Transplant In Press; DOI: 10.12659/AOT.934800
Most Viewed Current Articles
29 Dec 2021 : Original articleEfficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...
Ann Transplant 2021; 26:e933588
22 Dec 2021 : Original articleComparison of Coronary Artery Calcium Scoring with Dobutamine Stress Echo for Detection of Coronary Artery ...
Ann Transplant 2021; 26:e934163
01 Dec 2021 : Original articleSolid-Phase C1q/C3d Fixing Readouts Correlate with High Median Fluorescence Intensity (MFI) De Novo Donor-S...
Ann Transplant 2021; 26:e934175