Adolescence and Transfer to the Adult Clinic after Kidney Transplantation – Pediatric Aspects

In the long-term follow-up of children with kidney transplantation the transition to the adult clinic is associated with a high risk concerning graft function. Metabolic changes in puberty combined with the psychosocial development of the adolescents coincide with a new team of treatment. At the Medical School Hannover 61 adolescents were transferred from the pediatric to the adult clinic during the last decade. Serum-creatinine, the dosage and trough level of cyc-losporine were analysed 6 months before transfer, at time of transfer and 6 months thereafter. One patient only had lost the graft during transition. It could be demonstrated that with production of sex hormones the cyclosporine dosage could be reduced from 225 mg/m2 to 145 mg/m2 while the cyclosporine trough level stayed stable at 100 ng/ml. A coaching concept of transition is necessary in order to reduce the complication and to relieve the new start in the adult clinic.