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RISE to Transition: A Structured Transition Protocol for Renal Transplant Recipient

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Pediatric Solid Organ Transplantation

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Abstract

Introduction: The transition from pediatric to adult care is a challenging milestone for an adolescent with a renal transplant. Currently, there is no standardized transition protocol to guide this process for children with renal transplants culminating to medical non-adherence and subsequent graft failure.

Objectives: The principal objective of this review is to introduce the “RISE to Transition” protocol for smooth transition from pediatric to adult care, thereby reducing the incidence of graft failure. The RISE protocol relies on four competency areas: Recognition, Insight, Self-reliance, and Establishment of healthy habits.

Methodology: The RISE protocol was applied to a pilot study at Akron Children’s Hospital, Ohio. Seventeen patients (6 females and 11 males, mean age 14.5 years), who received a renal transplant in the preceding 2–9 years, went through the RISE transition protocols. This process spanned 2 years to overlap medical care between pediatric nephrologists and crucial adult physicians and related services with the final transition being completed at 21 years of age.

Results: The transition clinic provided sufficient time to prepare the patients to leave pediatric care for adult providers (satisfaction score 90%). Eighty five percent of patients and family felt well informed of the RISE protocol. The relevant issues during transfer were cited as medication (35%), education and employment (27%), disease knowledge (13%), and environment in the adult service (25%).

Limitations: RISE is limited by its high cost, lack of resources, and inconvenience during mobilization of healthcare in a single unit.

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Conflict of Interest

The authors declare that there is no conflict of interest.

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Author notes

  1. Rupesh Raina and Zubin Mahajan contributed equally with all other contributors.

Authors and Affiliations

  1. Department of Nephrology, Akron General Medical Center at Cleveland Clinic Foundation, and Akron Children’s Hospital, OH, USA

    Rupesh Raina

  2. Department of Nephrology, Cleveland Clinic Akron General/Akron Nephrology Associates, Akron, OH, USA

    Zubin Mahajan & Ronith Chakraborty

Authors
  1. Rupesh Raina
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  2. Zubin Mahajan
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  3. Ronith Chakraborty
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Corresponding author

Correspondence to Rupesh Raina .

Editor information

Editors and Affiliations

  1. Recanati/Miller Transplantation Institute, Mount Sinai Hospital, NY, USA

    Ron Shapiro

  2. Division of Transplant Surgery, University of California, San Francisco, CA, USA

    Minnie M. Sarwal

  3. Department of Nephrology, Akron General Medical Center at Cleveland Clinic Foundation and Akron Children’s Hospital, OH, USA

    Rupesh Raina

  4. Kidney and Urology Institute, Medanta, The Medicity, Gurugram, Haryana, India

    Sidharth Kumar Sethi

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Raina, R., Mahajan, Z., Chakraborty, R. (2023). RISE to Transition: A Structured Transition Protocol for Renal Transplant Recipient. In: Shapiro, R., Sarwal, M.M., Raina, R., Sethi, S.K. (eds) Pediatric Solid Organ Transplantation. Springer, Singapore. https://doi.org/10.1007/978-981-19-6909-6_8

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  • DOI: https://doi.org/10.1007/978-981-19-6909-6_8

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-6908-9

  • Online ISBN: 978-981-19-6909-6

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