ESPN 50th Annual Meeting

ESPN 2017


 
Current transition policy at European paediatric centres after kidney transplant
MARTIN KREUZER 1 LARS PAPE 1

1- DEPT. OF PAEDIATRIC NEPHROLOGY, HEPATOLOGY & METABOLIC DISEASES, HANNOVER MEDICAL SCHOOL
 
Introduction:

Transition in medical care is a high-risk period in adolescence and young adulthood for patients after kidney transplant (KTx). Some studies report unexpected loss rates in kidney grafts to be as high as 24% to 42% within 3 years after transfer of patients into adult care. In 2011 the International Society of Nephrology (ISN) and the International Paediatric Nephrology Association (IPNA) published a consensus statement on transition. Fifteen components were considered essential. To date, data on transition policy, its application in practice and transfer methods in Europe’s countries is scarce.

Material and methods:


A responsive online survey was developed and was distributed via ESPN e-mailing list twice to assess the transition-relevant structures from the providers’ perspective. Its content was mainly based on the 2011 ISN/IPNA consensus statement and previous research of our workgroup. The survey included multiple-choice and open questions, as well as 5 point Likert scales.

 

 

Results:

33 centres of 21 European countries participated in the survey to date. Most of them (85%) are university hospitals. A median number of 3 patients (0-15) is annually transferred to adult based care. In 2 centres children after KTx remain under paediatric care at all ages. 24/31 centres confirmed using an at least unwritten transition procedure (77%), which in most centres is introduced at age 14-16 (21%) or >18 (21%). 14/31 centres confirmed existence of at least one transition coordinator. Transition clinics are offered by 12 centres. Most centres transfer patients primarily to a university hospital (61%). Transfer age is subject of regulation at 15/33 centres. Most centres (48%) transfer patients commonly at age 18-19, 5 centres at age <18.

Conclusions:

The majority of European centres use a transition procedure. However, the implementation of the ISN/IPNA consensus guidelines on transition in clinical routine could be improved at many centers.