{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:26:27Z","timestamp":1790803587604,"version":"4.1.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100017590","name":"Universit\u00e4tsklinikum Essen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017590","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Allograft loss after pediatric kidney transplantation (KTx) is highest in adolescents and young adults. Non-adherence and Health Care Transition (HCT) are important factors, but others also contribute. In the TransNephro study patients were randomized 1:1. The intervention group was included in the Berlin Transition Program (BTP) and incorporated a central case manager, a communication app, and joined transition rounds for one year before and one year after transfer. Primary endpoint was the coefficient of variation (CoV) of the trough level of the calcineurin inhibitor as a surrogate marker for medication adherence associated with graft loss. Least square (LS) mean differences and corresponding 95% confidence intervals (CIs) were estimated using an analysis of covariance (ANCOVA) model. We assessed 220 patients for eligibility. 49 patients were randomized to the intervention group and 53 to the control group. We analyzed 84 patients in the modified intention-to-treat analysis (38 intervention, 46 controls) and 60 in the per protocol analysis (25 intervention, 35 controls). We found no difference in CoV. We saw low numbers of graft-related events and observed no differences with respect to quality of life. BTP did not improve adherence and other outcome parameters. Non-adherent patients may have decided not to participate, whilst adherence of participants was already good at study start. It is therefore achallenge to design future multicenter trials on HCT that include multiple interventions.<\/jats:p>\n                  <jats:p>\n                    Trial registration: ISRCTN22988897, 24\/04\/2014,\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"10.1186\/ISRCTN22988897\" ext-link-type=\"doi\">https:\/\/doi.org\/10.1186\/ISRCTN22988897<\/jats:ext-link>\n                    .\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-95845-7","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T18:10:44Z","timestamp":1743790244000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Results of a multicenter, randomized trial examining a new transition model for post-kidney transplant adolescents"],"prefix":"10.1038","volume":"15","author":[{"given":"Martin","family":"Kreuzer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Pr\u00fcfe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Luise","family":"Dierks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"M\u00fcther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Bethe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"B\u00fcscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krisztina","family":"Heindl-Rusai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Hollenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Hoppe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"John-Kroegel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele Kirsten","family":"Kanzelmeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcnter","family":"Klaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta","family":"Kranz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Pohl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Rieger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Ruckenbrodt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Sauerstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagen","family":"Staude","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Taylan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Thumfart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Weitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rieke","family":"Ringlstetter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika","family":"Gro\u00dfhennig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Pape","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"95845_CR1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1186\/1745-6215-15-505","volume":"15","author":"M Kreuzer","year":"2014","unstructured":"Kreuzer, M. et al. The TRANSNephro-study examining a new transition model for post-kidney transplant adolescents and an analysis of the present health care: study protocol for a randomized controlled trial. Trials 15, 505 (2014).","journal-title":"Trials"},{"issue":"10","key":"95845_CR2","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1007\/s00467-011-1981-z","volume":"26","author":"AR Watson","year":"2011","unstructured":"Watson, A. R. et al. Transition from pediatric to adult renal services: a consensus statement by the international society of nephrology (ISN) and the international pediatric nephrology association (IPNA). Pediatr. Nephrol. 26 (10), 1753\u20131757 (2011).","journal-title":"Pediatr. Nephrol."},{"issue":"5","key":"95845_CR3","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.1007\/s00431-022-04385-z","volume":"181","author":"L Pape","year":"2022","unstructured":"Pape, L. & Ernst, G. Health care transition from pediatric to adult care: an evidence-based guideline. Eur. J. Pediatr. 181 (5), 1951\u20131958 (2022).","journal-title":"Eur. J. Pediatr."},{"key":"95845_CR4","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1007\/s00467-014-2859-7","volume":"30","author":"BJ Foster","year":"2015","unstructured":"Foster, B. J. Heightened graft failure risk during emerging adulthood and transition to adult care. Pediatr. Nephrol. 30, 567\u2013576 (2015).","journal-title":"Pediatr. Nephrol."},{"key":"95845_CR5","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s00467-011-1980-0","volume":"27","author":"C Prestidge","year":"2012","unstructured":"Prestidge, C., Romann, A., Djurdjev, O. & Matsuda-Abedini, M. Utility and cost of a renal transplant transition clinic. Pediatr. Nephrol. 27, 295\u2013302 (2012).","journal-title":"Pediatr. Nephrol."},{"issue":"4","key":"95845_CR6","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1007\/s10157-018-1589-8","volume":"22","author":"W Kubota","year":"2018","unstructured":"Kubota, W. et al. A consensus statement on health-care transition of patients with childhood-onset chronic kidney diseases: providing adequate medical care in adolescence and young adulthood. Clin. Exp. Nephrol. 22 (4), 743\u2013751 (2018).","journal-title":"Clin. Exp. Nephrol."},{"issue":"16","key":"95845_CR7","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1016\/j.jacc.2018.02.043","volume":"71","author":"AS Mackie","year":"2018","unstructured":"Mackie, A. S., Rempel, G. R. & Kovacs, A. H. Transition intervention for adolescents with congenital heart disease. J. Am. Coll. Cardiol. 71 (16), 1768\u20131777 (2018).","journal-title":"J. Am. Coll. Cardiol."},{"issue":"6","key":"95845_CR8","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.2337\/dc18-2187","volume":"42","author":"T Spaic","year":"2019","unstructured":"Spaic, T. et al. Closing the Gap: results of the multicenter Canadian randomized controlled trial of structured transition in young adults with type 1 diabetes. Diabetes Care. 42 (6), 1018\u20131026 (2019).","journal-title":"Diabetes Care"},{"key":"95845_CR9","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jpeds.2017.05.066","volume":"188","author":"P Gabriel","year":"2017","unstructured":"Gabriel, P., McManus, M., Rogers, K. & White, P. Outcome evidence for structured pediatric to adult health care transition interventions: A systematic review. J. Pediatr. 188, 263\u2013269 (2017).","journal-title":"J. Pediatr."},{"issue":"2","key":"95845_CR10","first-page":"20200003","volume":"1","author":"J Becker","year":"2020","unstructured":"Becker, J., Ravens, E., Pape, L. & Ernst, G. Somatic outcomes of young people with chronic diseases participating in transition programs: a systematic review. J. Transit. Med. 1 (2), 20200003 (2020).","journal-title":"J. Transit. Med."},{"issue":"10","key":"95845_CR11","doi-asserted-by":"crossref","first-page":"e78547","DOI":"10.1371\/journal.pone.0078547","volume":"8","author":"S Becker","year":"2013","unstructured":"Becker, S. et al. User profiles of a smartphone application to support drug adherence\u2013experiences from the iNephro project. PLoS One. 8 (10), e78547 (2013).","journal-title":"PLoS One"},{"key":"95845_CR12","doi-asserted-by":"crossref","unstructured":"Moher, D., Hopewell, S. & Schulz, K. F. el al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 340, c869 (2010).","DOI":"10.1136\/bmj.c869"},{"issue":"8","key":"95845_CR13","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1097\/TP.0b013e31822dc34f","volume":"92","author":"M Hsiau","year":"2011","unstructured":"Hsiau, M., Fernandez, H. E., Gjertson, D., Ettenger, R. B. & Tsai, E. W. Monitoring nonadherence and acute rejection with variation in blood immunosuppressant levels in pediatric renal transplantation. Transplantation 92 (8), 918\u2013922 (2011).","journal-title":"Transplantation"},{"issue":"48","key":"95845_CR14","doi-asserted-by":"crossref","first-page":"e2196","DOI":"10.1097\/MD.0000000000002196","volume":"94","author":"M Kreuzer","year":"2015","unstructured":"Kreuzer, M. et al. Transitional care and adherence of adolescents and young adults after kidney transplantation in Germany and Austria: A binational observatory census within the transnephro trial. Med. (Baltim). 94 (48), e2196 (2015).","journal-title":"Med. (Baltim)."},{"key":"95845_CR15","doi-asserted-by":"crossref","unstructured":"Kim, E. J. et al. Clinical significance of tacrolimus intra-patient variability on kidney transplant outcomes according to pre-transplant immunological risk. Sci. Rep. 11, 12114 (2021).","DOI":"10.1038\/s41598-021-91630-4"},{"issue":"11","key":"95845_CR16","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.2215\/CJN.01640309","volume":"4","author":"GJ Schwartz","year":"2009","unstructured":"Schwartz, G. J. & Work, D. F. Measurement and estimation of GFR in children and adolescents. Clin. J. Am. Soc. Nephrol. 4 (11), 1832\u20131843 (2009).","journal-title":"Clin. J. Am. Soc. Nephrol."},{"issue":"3","key":"95845_CR17","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","volume":"34","author":"J Ware Jr","year":"1996","unstructured":"Ware, J. Jr, Kosinski, M. & Keller, S. D. A 12-Item Short-Form health survey: construction of scales and preliminary tests of reliability and validity. Med. Care. 34 (3), 220\u2013233 (1996).","journal-title":"Med. Care"},{"issue":"5","key":"95845_CR18","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.jclinepi.2014.11.003","volume":"68","author":"S Kliem","year":"2015","unstructured":"Kliem, S. et al. A brief form of the perceived social support questionnaire (F-SozU) was developed, validated, and standardized. J. Clin. Epidemiol. 68 (5), 551\u2013562 (2015).","journal-title":"J. Clin. Epidemiol."},{"issue":"6","key":"95845_CR19","doi-asserted-by":"crossref","first-page":"e015593","DOI":"10.1136\/bmjopen-2016-015593","volume":"7","author":"J Pr\u00fcfe","year":"2017","unstructured":"Pr\u00fcfe, J. et al. Transition structures and timing of transfer from paediatric to adult-based care after kidney transplantation in Germany: a qualitative study. BMJ Open. 7 (6), e015593 (2017).","journal-title":"BMJ Open."},{"issue":"3","key":"95845_CR20","first-page":"272","volume":"66","author":"K Drixler","year":"2020","unstructured":"Drixler, K., Morfeld, M., Glaesmer, H., Br\u00e4hler, E. & Wirtz, M. A. Validation of the Short-Form-Health-Survey-12 (SF-12 version 2.0) assessing health-related quality of life in a normative German sample. Z. Psychosom. Med. Psychother. 66 (3), 272\u2013286 (2020)  (German).","journal-title":"Z. Psychosom. Med. Psychother."},{"issue":"3","key":"95845_CR21","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/j.1399-0012.2011.01541.x","volume":"26","author":"MA Chisholm-Burns","year":"2012","unstructured":"Chisholm-Burns, M. A., Erickson, S. R., Spivey, C. A. & Kaplan, B. Health-related quality of life and employment among renal transplant recipients. Clin. Transpl. 26 (3), 411\u2013417 (2012).","journal-title":"Clin. Transpl."},{"issue":"4","key":"95845_CR22","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/j.jpeds.2013.04.066","volume":"163","author":"A Tong","year":"2013","unstructured":"Tong, A. et al. Quality of life of young adults and adolescents with chronic kidney disease. J. Pediatr. 163 (4), 1179\u201385e5 (2013).","journal-title":"J. Pediatr."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-95845-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-95845-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-95845-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T22:49:25Z","timestamp":1743806965000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-95845-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,3]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["95845"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-95845-7","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4503265\/v1","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,3]]},"assertion":[{"value":"30 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"11459"}}