A Novel Approach to Post-Transplant Care of Kidney and Pancreas Transplant Recipients, Inpatient Level Care in the Home

ABSTRACT

Purpose: Demonstrate safe and cost effective care of early kidney and pancreas post-transplant complications through the Advanced Care at Home (ACH) inpatient home-based care program. Method(s) 5 abdominal transplant patients were admitted into ACH over a 1-month period. Each recipient underwent transplant less than a year prior to admission. These recipients received ACH and transplant standard of care including 24-hour access to a physician-led virtual monitoring center, telehealth and home-based provider visits, skilled nursing care, rehabilitation, nutrition, pharmacy, laboratory, imaging, social work, and other individualized healthcare services in the comfort of the patients own home. Result(s) 5 Recipients, all within 1 year of transplant were admitted with diagnoses of CMV Viremia, Bacteremia, AKI, pancreas rejection, COVID 19 and volume overload. Two patients required escalation back to the brick-and-mortar hospital, one for a biopsy to rule out rejection, the second for new onset sepsis and progressive renal failure requiring hemodialysis. A total of 33 brick and mortar bed days were saved, freeing hospital capacity during a time of critical bed shortage. None of the patients were re-admitted within 30 days of discharge from ACH. Conclusion(s) Advanced care at home is a safe alternative to the traditional Brick an Mortar(B &M) hospitalization for patients admitted with complications post abdominal solid organ transplant. We improved bed capacity in the midst of the COVID 19 pandemic and minimized cost associated with a traditional B & M stay.