Background: Transition from pediatric to adult care services is a complex process, carrying medical, psychosocial and emotional issues. It is l known that during this process patients may drop out from follow up, lose their adherence and suffer from psychosocial complications .This period is prone to rejection of the transplanted kidney. M managing this process correctly, can empower the young adult and make him a better and more compliant patient.
The study was aimed to create a new model for Transition Clinic and analyze its impact on the transition process of young transplanted patients
Methods: Our model of Transition Clinic includes a multidisciplinary team - nephrologist, transplant coordinator, psychologist and social worker who built a "custom made" transition process for each patient according to his needs. The process ended with a gathering including group of patients about to transfer, the transition clinic staff and staff from the hospitals that will follow-up these patients.
Results: 22 patients already participated the new transition program. Participants reported that the process met their transition needs regarding informational, emotional and social issues. Most reported being `very much ready` and felt that the transition process helped them be more active and responsible for their medical care.
The group gathering at the end of the process was a substantial component, allowing them to meet other transitioning young adults and soften the transition itself.
Conclusions: Our model of Transition Clinic may be proposed for improving the transition process and optimizing the continuity of care of kidney transplanted patients.
