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Transition of young adult kidney transplant recipients

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Abstract

Survival of pediatric kidney transplant recipients has improved over the past six decades. However, adolescents and young adults still have the highest graft failure rates of any age group. There is a growing need for well-designed transition programs to ensure the successful integration of young adults into adult society with eventual transfer of care and management in adult transplant centers. In this review, we discuss the risk factors contributing to the high risk of kidney graft failure observed between 17 and 24 years of age, including the role of transfer from pediatric to adult care. We also address the unique challenges of adolescents with kidney transplant: the impact of chronic kidney disease on neurocognition, age-related changes in immune activity, and suboptimal adherence during the transition process. We then describe strategies to mitigate these risks by designing developmentally appropriate transition programs, and review the evidence supporting the benefits of well-designed multidisciplinary transition programs.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Canada

    Mina Matsuda-Abedini

  2. NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, UK

    Stephen D. Marks

  3. Department of Paediatric Nephrology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK

    Stephen D. Marks

  4. Department of Pediatrics, McGill University, Montreal, Canada

    Bethany J. Foster

  5. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada

    Bethany J. Foster

  6. Research Institute of the McGill University Health Centre, McGill University, Montreal, Canada

    Bethany J. Foster

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  1. Mina Matsuda-Abedini
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Correspondence to Mina Matsuda-Abedini.

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Answers 1. b 2. d 3. c 4. b 5. a.

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Matsuda-Abedini, M., Marks, S.D. & Foster, B.J. Transition of young adult kidney transplant recipients. Pediatr Nephrol 38, 383–390 (2023). https://doi.org/10.1007/s00467-022-05582-6

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