For a comparison of the group with good adherence with the others see Table4. == TABLE 4. agreements on transitional care. More than half of the patients had CoV of immunosuppression trough levels consistent with good adherence. Although, 20% of the patients showed increase in serum creatinine close to transfer. == INTRODUCTION == About 80% of adolescents between 15 and 18 years of age with end-stage renal disease in Germany have a functioning kidney transplant. In this age group, loss of transplant JX 401 was observed to be 2% to 3% per year. 1In the USA and Canada, more transplanted kidneys are lost in patients aged 13 to 25 years than in any other age group. 2Such graft failure requires a return to dialysis, which reduces quality of life and leads to considerable additional healthcare expense. Moreover, early graft losses increase morbidity and mortality, and shorten life expectancy. Graft failure rates increase from the age of 13 and peak between 17 and 24 years of age regardless of age at transplantation. 3Two major risk factors aggravate this situation in adolescents and young adults coming of age: First, poor treatment adherence is considered a main cause of increased risk for graft failure. Secondly, transition from pediatric to adult care, disrupting the continuity of medical care during a difficult developmental period, results in a further increase of risk. Some studies report unexpected kidney graft failure rates within 3 years after transfer to be as high as 24% to 35%. 4, 5 Medication adherence and adherence to general care (eg, clinic appointments) deteriorate during adolescence and emerging adulthood. 6Increasing independence from their parents, less time under direct adult supervision and assuming more responsibility for medication and overall management of their condition may lead to poorer adherence in adolescents and young adults in comparison to children. 2Identifying and monitoring medication nonadherence in the adolescent and young adult kidney JX 401 transplant population remains challenging for clinicians. Since measurement of blood medication levels is a standard practice to monitor adequacy of immunosuppression in transplanted patients, these levels can serve as surrogate parameters for patient adherence. 7Coefficient of variation (CoV%) of immunosuppressant levels can be used, as well as the percentage of subtherapeutic levels over a given time. 8 In nephrology in particular, transition constitutes an important intersection in patient care. 2, 9Transition can be considered successful if it promotes the patients health competence, supports their psychosocial rehabilitation, and improves their self-determination efficacy, including their ability to make decisions and communicate about their care. The overarching goal of transition is to enable patients to be as independent as possible and have the best possible quality of life. Historically, a lack of cooperation among the various professionals involved in treatment, and concomitant care has led to medical care issues for patients, which is particularly problematic in the transition phase. From an analysis of such deficiencies, it is possible to derive strategies for establishing a satisfactory patient-centered transition. 1012Training programs, such as Finally Grown Up (Endlich-Erwachsen)13and computer-based training courses, 14have been Egf shown to produce some improvements in the transition of postkidney transplant adolescents into adult medical care. At present, it is unclear, how transition is performed after kidney transplantation (KTX) in German and Austrian centers and which, if any, transition models are applied. Therefore , this observational study aims to evaluate transition, adherence, and outcome of adolescents after KTX in all centers for pediatric KTXs of both nations. == METHODS == A retrospective analysis of the existing structures was carried out on-site at each of 22 pediatric nephrology centers, which treat pediatric renal transplant recipients in Germany and Austria as the first phase of the TRANSNephro study. The study has been registered at ISRCTN Registry (No. 22988897), and the study protocol was published December 2014. 15The TRANSNephro-study consists of 2 parts. Part 1, the analysis of the existing mode of JX 401 transition is reported in the present paper. Part 2, the examination of a new transition model for postkidney transplant adolescents, is still ongoing. Data for this study were assessed.