Study reveals high-risk window for kidney transplant failure

New research shows young people aged 15-25 are most likely to suffer kidney transplant failure due to non-compliance with medications, underlining the need for targeted care.

Head of Nephrology at Sydney Children’s Hospital, Randwick and UNSW School of Women's and Children's Health Director of Education, Dr Sean Kennedy, led a study published in Nephrology that highlights the age-related risk seen in adolescents and young adults with kidney transplants.

The risk of losing a kidney from rejection and non-compliance was 11 times higher for 16-21 year olds compared to younger children and at least double that of older adults.

The study shows the high rates of transplant failure in adolescents and young adults are related to non-adherence with medications. Of 3048 recipients examined from the ANZDATA registry, 757 transplants failed and 15% of those were due to non-adherence.

Adolescents who receive kidney transplants have to take multiple medications to stop rejection after surgery. Not taking medications, even years after surgery puts them at risk of rejection and transplant failure.

Dr Kennedy says there’s also high rates of non-adherence in adolescents with other chronic conditions, like asthma, diabetes and epilepsy.

“All the behavioural and social changes that occur in adolescence and early adulthood lead to a higher risk of non-adherence,” he says.

“These young people are balancing a busy social life with study, work and other commitments.”

The study highlights the need for new approaches for this age group, and Sydney Children’s Hospital, Randwick is leading the way in this through care delivered at the new Centre for Adolescent and Young Adult Health, an Australian-first dedicated and purpose-built Outpatients service for adolescents and young adults located  in The Bright Alliance building at Randwick.

At the Centre for Adolescent and Young Adult Health, managed by Sydney Children’s Hospitals Network, young people benefit from more personalised, centralised care and extra support in the form of case management.

There are transition clinics focusing on supporting self-management skills for patients entering the adult health system, and there is screening and support not only for non-adherence to medications but other health issues specific to the age group including mental health problems.