Growing pains: Non‐adherence with the immunosuppressive regimen in adolescent transplant recipients

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.