*Purpose: Transition refers to the dynamic process in which the patient is oriented from pediatric to adult care. In the field of kidney transplantation, transition is particularly challenging for nephrologists and young kidney transplant recipients, since it may interfere with adherence to immunosuppressant medication and worsen transplantation outcome.

*Methods: We studied a monocentric retrospective cohort of 75 kidney transplant recipients who were transferred from pediatric to adult care between December 2007 and October 2017. Transition was defined as the date of the patient’s first appointment with an adult nephrologist. A minimum follow-up period of 1 year after transfer was required. In order to evaluate transplantation outcome after transition, we examined the estimated glomerular filtration rate (eGFR) at 12 months, together with the prevalence of graft loss and acute rejection in the post-transition period. Then, we analyzed the specific factors associated with graft loss after transition.

*Results: Patients were transferred at the mean age of 23 ± 4 years old and at a wide range of times since the date of transplantation, from 1 to 23 years (mean time ± SD of 9.9 ± 5.2 years). The mean eGFR was 71 ± 27 ml/min/1,73m² at transition, and remained stable 12 months after transition. The most common immunosuppressive regimen (38% of patients) associated tacrolimus, mycophenolate acid and corticosteroid. In the post-transition period, 9 (12%) patients underwent one acute rejection episode and 13 (17%) lost their kidney allograft, among which 11/13 returned to long-term dialysis and 8/13 were retransplanted. No death was examined. The average time between transition and graft loss was 32 months. Infections represented the most common complication in the post-transition period (39%), followed by iatrogenic events (21%) and neoplastic complications (16%). In univariate analysis, younger age at transition, shorter period between transition and transplantation and lower eGFR at transition were positively associated with allograft loss.

*Conclusions: These data suggest that transition has no deleterious impact on transplantation outcomes. It seems important not to accelerate too much the transition process.

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