Incidence of and Risk Factors for Multiple Readmissions after Kidney Transplantation

2020 ◽  
Vol 86 (2) ◽  
pp. 116-120
Author(s):  
Jessica Schucht ◽  
Eric G. Davis ◽  
Christopher M. Jones ◽  
Robert M. Cannon
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Acute Rejection ◽  
Deceased Donor ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Unplanned readmission is often used as a surgical quality metric. A subset of kidney transplant recipients undergos multiple readmissions (MRs), although the incidence and risk factors are not well described. The aim of this study was to evaluate risk factors for MR after deceased donor kidney transplantation. All patients undergoing deceased donor kidney transplantation at a single center over a three-year period were analyzed via retrospective chart review for factors associated with MR. P values <0.05 were considered significant. Of 141 patients, the 30-day readmission rate was 26.2 per cent. MR occurred in 43 (30.5%) patients. Age, race, gender, initial organ function, and dialysis vintage were not associated with MR. Diabetic recipients, those who received basiliximab induction, those with acute rejection, and those with unplanned reoperations were at increased risk for MR. Infection was the most common reason for initial readmission in patients with MR (23.3%). One-year patient survival and death-censored graft survival were reduced for patients with MR. MRs are required for 30 per cent of kidney transplant recipients, primarily because of infection and immunologic causes. Recipients with diabetes and those who have acute rejection are at greatest risk.

scholarly journals Risk factors for delayed graft function in deceased donor kidney transplantation; a potential preventive role for intraoperative thymoglobulin

2019 ◽  
Vol 8 (2) ◽  
pp. 157-163
Author(s):  
Neda Naderi ◽  
Azam Alamdari ◽  
Mahboob Lessan-Pezeshki ◽  
Simin Dashti-Khavidaki ◽  
Mehran Heydari-Seradj ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Kidney Transplantation ◽  
Odds Ratio ◽  
Graft Function ◽  
Deceased Donor ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Introduction: Delayed graft function (DGF) is associated with significant adverse outcomes in deceased donor kidney transplantation (KT) including lower graft survival. However, risk factors and potential preventive strategies like intraoperative rabbit antithymocyte globulin (rATG; thymoglobulin) have not yet been fully evaluated. Objectives: The aim of this study was to investigate DGF risk factors and determine the association of intraoperative rATG with the risk of DGF in deceased donor kidney recipients. Patients and Methods: We retrospectively examined medical records of 163 first time deceased donor kidney transplant recipients at two major kidney transplant centers from 2014 to 2016. All the donors were standard heart-beating, brain death donors. Risk factors for DGF in recipients were evaluated using multivariate logistic regression analysis. Results: The mean recipients’ age was 43±13 years and the majority of participants were male (64%). The overall rate of DGF was 27%. Intraoperative rATG was significantly associated with a lower rate of DGF (adjusted odds ratio [AOR], 0.33, 95% CI, 0.11-0.95). Intraoperative transfusion (AOR, 3.7, 95% CI, 1.4-9.9) and diabetes mellitus (AOR, 3.7, 95% CI, 1.5-8.9) were significantly associated with higher risk of DGF. Conclusion: This study showed that intraoperative blood transfusion and diabetes mellitus were associated with increased risk of DGF. Meanwhile, administration of intraoperative rATG was associated with reduced odds ratio of DGF. Future studies are needed to evaluate the potential role of rATG in DGF-related renal outcomes.

scholarly journals Independent Risk Factors for Urological Complications after Deceased Donor Kidney Transplantation

PLoS ONE ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. e91211 ◽  
Author(s):  
Inez K. B. Slagt ◽  
Jan N. M. IJzermans ◽  
Laurents J. Visser ◽  
Willem Weimar ◽  
Joke I. Roodnat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Deceased Donor ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Urological Complications ◽  
Independent Risk Factors ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

scholarly journals Risk factors for rejection after deceased donor kidney transplantation: a mono-institutional analysis of paired kidneys

2021 ◽  
Author(s):  
Fuxun Zhang ◽  
Zhihong Liu ◽  
Jiayu Liang ◽  
Yang Xiong ◽  
Changjing Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Uric Acid ◽  
Kidney Transplantation ◽  
Deceased Donor ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Hla Dq ◽  
Deceased Donors ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Abstract Background Deceased donor kidney transplantation is an important therapeutic option for end-stage renal diseases. Adverse events including acute rejection after deceased donor kidney transplantation are not uncommon and result in poor transplant outcomes. Exploration of risk factors and patient stratification is increasingly significant to improve graft survival. This study aim to evaluate and identify the risk factors for treated rejection of patients after deceased donor kidney transplantation. Methods Clinical and immunological data of deceased donors and corresponding recipients between 2015 and 2018 in West China Hospital were retrospectively collected. The Kolmogorov-Smirnov test was used to indicate distribution of variables. Univariate comparisons of baseline characteristics were made with Chi-square, t and Mann-Whitney U tests. Logistic regression was constructed to analysis potential risk factors. Receiver operating characteristic curve and Jordan index were generated to determine optimal cut-off value for continuous variables. Results Data of 123 deceased donors and 246 recipients were obtained. The median (range) age was 41(4–62) years in recipients and 39 (1–65) years in donors. The recipients who died or suffered graft loss during the follow-up period were 8 (3.3%) and 12 (4.9%) respectively. After univariate analysis and subsequent multivariate analysis, some preoperative hemato-biochemical and transplantation-related parameters including uric acid (HR 2.132, 95%CI: 1.016–4.476, P = 0.045), platelet (HR 2.202, 95%CI:1.051–4.617, P = 0.037), absolute neutrophil count (HR 2.164, 95%CI:1.018–4.599, P = 0.045) and HLA-DQ mismatch (HR 2.197, 95%CI:1.119–4.317, P = 0.022) showed statistical significance and could be considered as independent predictors for treated rejection. Conclusions Including unexpected serum uric acid, several hemato-biochemical and transplantation-related parameters were found to be independent risk factors for rejection, which may contribute to stratify patients and develop personalized regimen in perioperative period.

Modifiable Risk Factors for Delayed Graft Function After Deceased Donor Kidney Transplantation

2019 ◽  
Vol 29 (3) ◽  
pp. 269-274 ◽  
Author(s):  
Kai B. Kaufmann ◽  
Wolfgang Baar ◽  
Kai Silbach ◽  
Julian Knörlein ◽  
Bernd Jänigen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Graft Function ◽  
Deceased Donor ◽  
Delayed Graft Function ◽  
Patient Specific ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Purpose: Delayed graft function is a major complication after kidney transplantation affecting patients’ long-term outcome. The aim of this study was to identify modifiable risk factors for delayed graft function after deceased donor kidney transplantation. Methods: This is a single-center retrospective cohort study of a university transplantation center. Univariate and multivariate step-wise logistic regression analysis of patient-specific and procedural risk factors were conducted. Results: We analyzed 380 deceased donor kidney transplantation patients between October 30, 2008 and December 30, 2017. The incidence of delayed graft function was 15% (58/380). Among the patient-specific risk factors recipient diabetes (2.8 [1.4-5.9] odds ratio [OR] [95% confidence interval [CI]]), American Society of Anesthesiologist score of 4 (2.7 [1.2-6.5] OR [95% CI]), cold ischemic time >13 hours (2.8 [1.5-5.3] OR [95% CI]) and donor age >55 years (1.9 [1.01-3.6] OR [95% CI]) revealed significance. The significant intraoperative, procedural risk factors included the use of colloids (3.9 [1.4-11.3] OR [95% CI]), albumin (3.0 [1.2-7.5] OR [95% CI]), crystalloids >3000 mL (3.1 [1.2-7.5] OR [95% CI]) and mean arterial pressure <80 mm Hg at the time of reperfusion (2.4 [1.2-4.8] OR [95% CI]). Conclusion: Patients undergoing deceased donor kidney transplantation with a mean arterial pressure >80 mm Hg at the time of transplant reperfusion without requiring excessive fluid therapy in terms of colloids, albumin or crystalloids >3000 mL are less likely to develop delayed graft function.

Sign in / Sign up

Export Citation Format

Share Document