Growing pains: non-adherence with the immunosuppressive regimen in adolescent transplant recipients

Pediatr Transplant. 2005 Jun;9(3):381-90. doi: 10.1111/j.1399-3046.2005.00356.x.


One-year graft and patient survival are better in adolescent transplant recipients (age 11-19 years) than in younger (age < 11 years) pediatric transplant recipients. However, several groups found that long-term outcomes (> i.e. 5 year post-transplant) in the adolescent age group are significantly worse than in younger transplant recipients. A behavioral factor that could explain an important part of the poorer clinical outcome in adolescent transplant recipients is non-compliance with medication taking. Adolescents, like all organ transplant recipients irrespective of their age, must adhere to a life-long immunosuppressive regimen in addition to other aspects of their therapeutic regimen. Therefore, adolescent transplant recipients, as all transplant patients, should be regarded as a chronically ill patient population in whom behavioral and psychosocial management is equally important as state-of-the-art medical management. This paper provides an overview of the current knowledge on prevalence, clinical consequences, and risk-factors for non-compliance with the immunosuppressive regimen in adolescent transplant recipients and offers some suggestions for adolescent-tailored interventions to improve medication adherence.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Graft Rejection / psychology
  • Graft Survival
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Transplantation / immunology
  • Patient Education as Topic
  • Risk Factors
  • Social Support
  • Transplants*
  • Treatment Outcome
  • Treatment Refusal* / psychology
  • Treatment Refusal* / statistics & numerical data


  • Immunosuppressive Agents