The Adolescent Transplant Recipient Miriam Kaufman, MD a,b, *, Eyal Shemesh, MD c,d , Tami Benton, MD e,f Adolescents constitute a significant proportion of pediatric transplant patients, whether they have survived a transplant in early childhood (like most heart and liver recipients) or are transplanted in older childhood or adolescence, such as many renal transplant recipients. Their needs can be significantly different from either children or adults, as they are undergoing a major transformation that involves making educational and voca- tional decisions and commitments, establishing a new and more equal relationship with their parents, discovering their sexual identity, taking increasing responsibility for their health and creating the moral, philosophic, and ethical perspective that they will carry through their lives. Research addressing adolescence and transplantation should be an important focus in the future. Adolescent issues identified as research foci at a 2003 pediatric transplant consensus conference include adolescent graft survival, growth and the pubertal hormonal axis, quality of life, adherence, and alterations in drug metabolism. 1 This article discusses adolescent issues in transplantation. THE ADOLESCENT INTERVIEW Talking with adolescents does not have to be difficult nor particularly time consuming. To lay the groundwork, a discussion of confidentiality and its limits will make it clear what can be kept private and what cannot. This varies between jurisdictions, but a The Transplant Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada b Division of Adolescent Medicine, Department of Paediatrics, The University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada c Division of Behavioral Pediatrics, Department of Pediatrics, Mount Sinai Medical Center, Box 1198, 1 Gustave L Levy Place, New York, NY 10029, USA d Mount Sinai School of Medicine, New York, NY, USA e The Children’s Hospital of Philadelphia, Behavioral Health Center, 3440 Market Street, Suite 200, Philadelphia, PA 19104, USA f Department of Psychiatry, The Children’s Hospital of Philadelphia, Behavioral Health Center, University of Pennsylvania School of Medicine, 3440 Market Street, Suite 200, Philadelphia, PA 19104, USA * Corresponding author. Division of Adolescent Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada. E-mail address: miriam.kaufman@sickkids.ca KEYWORDS  Adolescent  Transplant  Adherence Pediatr Clin N Am 57 (2010) 575–592 doi:10.1016/j.pcl.2010.01.013 pediatric.theclinics.com 0031-3955/10/$ – see front matter ª 2010 Elsevier Inc. All rights reserved.