Optimizing the transition of care in pediatric kidney transplant recipients at a tertiary center: strategies to enhance autonomy and treatment adherence

Transition from pediatric to adult care represents a vulnerable period for adolescent kidney transplant recipients. This study describes the implementation and preliminary evaluation of a structured multidisciplinary transition program at a tertiary-care university hospital. Transition readiness was assessed using an institutional transition-readiness questionnaire, completed by adolescents and parents, together with clinician-reported transition readiness assessments by pediatric and adult nephrologists. Among 51 screened kidney transplant recipients, 34 were eligible, and 10 adolescents (mean age 18.1 ± 1.4 years) completed the assessment. Overall readiness was high, with 74.4% of responses indicating full autonomy (score 1) and a mean score of 1.3 on a three-point scale. Readiness was highest in emotional regulation, lifestyle, and communication, whereas lower autonomy was observed in medical care management, particularly medication organization and healthcare navigation. Parents perceived adolescents as less autonomous than adolescents’ self-assessments, while pediatric nephrologists tended to provide more cautious evaluations than adult nephrologists. A novel aspect of this study was the integration of adolescent, parent, pediatric nephrologist, and adult nephrologist perspectives into a multidimensional assessment of transition readiness. Structured multidisciplinary transition programs may support individualized transition planning, promote patient autonomy, and ensure continuity of care.