Renal allograft loss during transition to adult healthcare services among pediatric renal transplant patients

Transplantation. 2009 Jun 15;87(11):1733-6. doi: 10.1097/TP.0b013e3181a63ed9.

Abstract

Background: Transition to adult care occurs at age 18 during a vulnerable adolescent period for pediatric renal transplant (RTx) patients.

Methods: We examined renal allograft loss and hospitalization for RTx biopsy or rejection before and after transition to adult care using clinical and administrative health records of children who underwent RTx (1992-2002) in Ontario, Canada. Life-table analyses examined event rates/100 person years according to age at first RTx.

Results: A total of 115 patients were included (57% men; mean age at first transplant 13.9+/-3.7 years). Allograft loss rates were similar across ages 14.0 to 23.9 years. No increase in allograft loss was observed during transition period (ages 18.0-19.9 years). Hospitalizations for RTx rejection or biopsy were much lower after age 18.

Conclusions: Our findings do not support an increased risk of allograft loss after transition to adult care, although there is less hospital use for rejection or biopsy suggesting that differences exist in use of care before complete allograft loss after transition to adult care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aging / immunology*
  • Child
  • Cytomegalovirus Infections / epidemiology
  • Delivery of Health Care / organization & administration*
  • Graft Rejection / immunology
  • Graft Rejection / pathology
  • Graft Survival / immunology
  • Humans
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / immunology*
  • Kidney Transplantation / pathology
  • Kidney Transplantation / statistics & numerical data*
  • Ontario / epidemiology
  • Pediatrics
  • Quality Assurance, Health Care / standards
  • Quality Assurance, Health Care / statistics & numerical data*
  • Risk Factors
  • Treatment Failure