Reingreso precoz después del trasplante renal: lecciones aprendidas / Early readmissions post kidney transplantation: Lessons learned

Introducción El trasplante renal es el tratamiento de referencia para los pacientes con enfermedad renal terminal. Los reingresos hospitalarios tras el trasplante son una complicación frecuente y pueden considerarse un indicador de morbilidad evitable y de la calidad de la asistencia hospitalaria, y existe una correlación significativa entre reingreso hospitalario precoz (RHP) y resultados adversos para los pacientes. Este estudio pretende evaluar la tasa de reingresos tras el trasplante renal, las causas subyacentes y las posibles maneras de prevenirlo. Material y métodos Se revisaron retrospectivamente las historias clínicas de los receptores desde enero de 2016 hasta diciembre de 2021 en un único centro. El objetivo principal de este estudio es determinar la tasa de reingreso después del trasplante renal y las variables que contribuyen al reingreso. Las complicaciones postrasplante que dieron lugar al reingreso se clasificaron en complicaciones quirúrgicas, complicaciones relacionadas con el injerto, infecciones, trombosis venosa profunda (TVP) y otras complicaciones médicas. Resultados Cuatrocientos setenta y cuatro receptores de aloinjerto renal cumplieron nuestros criterios de inclusión y se adhirieron al estudio. De estos, 248 (52,3%) tuvieron al menos un reingreso durante los primeros 90días tras el trasplante. Un total de 89 (18,8%) receptores de aloinjerto tuvieron más de un episodio de reingreso en los primeros 90días postrasplante. La colección líquida perirrenal fue la complicación quirúrgica más frecuente (52,4%), y la infección del tracto urinario fue la infección más común (50%) entre las causas de reingreso en los primeros 90días postrasplante. El cociente de probabilidades (odds ratio [OR]) de reingreso fue significativamente mayor en los pacientes mayores de 60años y en los riñones con KDPI ≥85, así como en los receptores con RFI (AU)

Introduction Kidney transplantation (KT) is the gold standard treatment for end-stage renal disease (ESRD) patients. Hospital readmissions post-transplant is a common complication and can be considered an indication of avoidable morbidity and hospital quality, and there is a significant correlation between early hospital readmission (EHR) and adverse patient outcomes. This study aimed to assess the readmission rate following kidney transplants, the underlying causes, and possible ways to prevent it. Material and methods We retrospectively reviewed the medical records of recipients from January 2016 to December 2021 in a single center. The primary objective of this study is to find the readmission rate for kidney transplants and the variables that contribute to readmission. Post-transplant complications that were resulted in the readmission categorized into surgical complications, graft-related complications, infections, DVT, and other medical complications. Results Four hundred seventy-four renal allograft recipients met our inclusion criteria and were included in the study. 248 (52.3%) of the allograft recipients had at least one readmission during the first 90days after the transplantation. 89 (18.8%) allograft recipients had more than one readmission episode in the first 90days post-transplant. The perinephric fluid collection was the most common surgical complication (52.4%), and UTI was the most common infection (50%), causing readmission in the first 90days post-transplant. The readmission odd ratio was significantly higher in patients above 60years old and in kidneys with KDPI ≥85, and in recipients with DGF. Conclusion EHR following a kidney transplant is a common complication. Identifying the causes not only helps the transplant centers to take further steps to prevent some incidents and help to improve the patients’ morbidities and mortalities, but also it can reduce the unnecessary costs of readmissions (AU)

Early readmissions post kidney transplantation: lessons learned.

INTRODUCTION: Kidney transplantation (KT) is the gold standard treatment for end-stage renal disease (ESRD) patients. Hospital readmissions post-transplant is a common complication and can be considered an indication of avoidable morbidity and hospital quality, and there is a significant correlation between EHR and adverse patient outcomes. This study aimed to assess the readmission rate following kidney transplants, the underlying causes, and possible ways to prevent it. MATERIAL AND METHODS: We retrospectively reviewed the medical records of recipients from January 2016 to December 2021 in a single center. The primary objective of this study is to find the readmission rate for kidney transplants and the variables that contribute to readmission. Post-transplant complications that were resulted in the readmission categorized into surgical complications, graft-related complications, infections, DVT, and other medical complications. RESULTS: Four hundred seventy-four renal allograft recipients met our inclusion criteria and were included in the study. 248 (52.3%) of the allograft recipients had at least one readmission during the first 90 days after the transplantation. 89 (18.8%) allograft recipients had more than one readmission episode in the first 90 days post-transplant. The perinephric fluid collection was the most common surgical complication (52.4%), and UTI was the most common infection (50%), causing readmission in the first 90 days post-transplant. The readmission odd ratio was significantly higher in patients above 60 years old and in kidneys with KDPI ≥ 85, and in recipients with DGF. CONCLUSION: Early hospital readmission (EHR) following a kidney transplant is a common complication. Identifying the causes not only helps the transplant centers to take further steps to prevent some incidents and help to improve the patients' morbidities and mortalities, but also it can reduce the unnecessary costs of readmissions.