Adolescents who have their first kidney transplant between 14 and 16 years of age could have a higher risk of transplant failure, according to a study published in the journal JAMA Internal Medicine.

Researchers from the University of Florida, Gainesville, analyzed 168,809 patients between 1987 and 2010. All participants had their first kidney transplant and their ages ranged up to 55.

Data was analyzed from the Organ Procurement Transplantation Network Standard Transplant Analysis and Research Database.

The study population characteristics analyzed in the study included the recipients’ sex, race and insurance type, and the donors’ living vs deceased status, sex, health and their combined Human Leukocyte Antigens (HLA) match information.

Results of the study showed that patients aged between 14 and 16 years had the highest risk of graft loss of all age groups.

The researchers found that graft loss started at 1 year after the transplant was carried out, and increased at 3-, 5- and 10-year points.

The study also revealed that black adolescents have an even higher risk of graft failure, compared with non-black adolescents.

The study authors say that using age at transplant as the risk factor, there was a decreasing relative hazard of graft failure in different insurance groups.

The researchers found the following range, in order of highest to lowest, for graft failure risk:

  • Deceased donor – government insurance group
  • Deceased donor – private insurance group
  • Living donor – government insurance group
  • Living donor – private insurance group

They add that in the death-censored analysis, this order of risk was consistent from infancy to 55 years of age.

Additionally, the results showed that among 14-year-old patients, there was an increased death risk of 175% in the deceased donor-government insurance group, compared with the living donor-private insurance group.

The researchers conclude that comprehensive programs are needed for adolescent transplant recipients, as current medical literature “does not adequately describe the risks of graft failure among kidney transplant recipients by age.”

They say: “The realization that this age group is at an increased risk of graft loss as they are becoming young adults should prompt providers to give specialized care and attention to these adolescents in the transition from pediatric to adult-focused care.”

The researchers conclude:

“Implementing a structured health care transition preparation program from pediatric to adult-centered care in transplant centers may improve outcomes.”