Abstract
ObjectiveThe aim of our study was to evaluate the incidence, causes, risk factors, outcomes, and cost of hospital readmission after live related renal transplantation (LRRT).MethodsWe conducted a cross-sectional study and followed patients’ re-admissions for six months whose LRRT was done in our center between September 2019 and June 2020.ResultsWe recruited 53 patients, 40 (75.5%) were male. The mean age was 36.9 ± 11.9 years. Donor gender was similar, and their mean age was 31.6 ± 9.2 years. The mean length of hospital stay after LRRT was 14 ± 2.2 days. A total of 81.1% were readmitted after LRRT within the first six months, with a total of 113 readmissions. The median time of readmission after LRRT was 66 days. The median readmission hospital stay was four days. The causes of readmission were surgical in 11 (9.7%), medical in 89 (78.8%), and combined medical and surgical in 13 (11.5%). Infection was the most common medical cause, followed by rejection. Statistically significant difference between readmission and non-readmission groups was found in estimated glomerular filtration rate (eGFR) at six month 61.3 ± 25.9 vs. 84.3 ± 36.1 mL/min/1.73 m2 respectively (p = 0.02). The median cost of readmission was PKR 40629, equivalent to USD 261.ConclusionOver three-fourths of the patients were readmitted after LRRT within the first six months. The most common causes were infection and rejection. Readmissions after LRRT are associated with lower graft function at six months and a significant cost burden on the health system.
Highlights
Since the first renal transplant by Murray in 1954 [1], it is considered the treatment of choice for patients with end-stage kidney disease (ESKD)
Significant difference between readmission and non-readmission groups was found in estimated glomerular filtration rate at six month 61.3 ± 25.9 vs. 84.3 ± 36.1 mL/min/1.73 m2 respectively (p = 0.02)
Readmissions after live related renal transplantation (LRRT) are associated with lower graft function at six months and a significant cost burden on the health system
Summary
Since the first renal transplant by Murray in 1954 [1], it is considered the treatment of choice for patients with end-stage kidney disease (ESKD). It offers improvements in life expectancy and quality of life for most patients compared to remaining on dialysis [2,3]. Re-hospitalization after renal transplant surgery is common [4,5], because of the complexity of immunosuppression regimens, rejection, infection, and other transplant-specific complications and has been shown to have a significant impact on the health care cost, morbidity, graft loss, and death [4,6,7]. The majority of the infections are seen within 1-6 months [10] and found to be a significant problem in developing countries post-transplant [11]
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