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Implementation of a transition model to adult care may not be enough to improve results: National study of kidney transplant recipients
- Source :
- Clinical Transplantation. :e13449
- Publication Year :
- 2018
- Publisher :
- Wiley, 2018.
-
Abstract
- Adolescents with a kidney transplant (KT) require special attention during the transition of care. Few longitudinal studies have assessed the effect of transition models (TM) on patient outcomes. Between 1986 and 2013, 239 pediatric patients underwent KT in Finland, of whom 132 have been transferred to adult care. In 2005, a TM was developed following international recommendations. We compared patient (PS) and graft survival (GS) rates before and after the introduction of the TM. PS and GS at 10 years were similar before and after the implementation of the TM (PS 85% and 90% respectively, P = 0.626; GS 60% and 58%, respectively, P = 0.656). GS was lower in patients transplanted at age 10-18 than in patients transplanted at a younger age in the TM cohort (79% vs 95%, P < 0.001). During the first five years after transfer, 63% of patients had stable KT function, 13% had deteriorating function and 24% lost their KT. Altogether 32 out of 132 patients lost their kidney allograft within five years after transfer to adult care (13 before and 19 after TM implementation, P = 0.566). The implementation of this TM had no effect on PS or GS. Further measures to improve our TM are in progress.
- Subjects :
- Adult
Male
Transition to Adult Care
medicine.medical_specialty
Younger age
Adolescent
Adult care
Kidney transplant
03 medical and health sciences
0302 clinical medicine
Quality of life
Risk Factors
030225 pediatrics
Internal medicine
medicine
Humans
030212 general & internal medicine
Young adult
Child
Kidney transplantation
Retrospective Studies
Transplantation
business.industry
Graft Survival
Health Plan Implementation
Prognosis
medicine.disease
Kidney Transplantation
Transplant Recipients
3. Good health
Survival Rate
Models, Organizational
Cohort
National study
Kidney Failure, Chronic
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 13990012 and 09020063
- Database :
- OpenAIRE
- Journal :
- Clinical Transplantation
- Accession number :
- edsair.doi.dedup.....6972f6b8b7df4159641737e412b5d7fa