The "weekend effect" describes increased adverse events and outcomes for patients hospitalized on weekends due to limited resources at hospitals and – in the context of renal transplantation (RTx) – has also been shown to affect the organ discard rate of deceased donor kidneys.

We examined weekend-weekday differences in the outcome of 580 patients following RTx (brain dead donors) between January 2007 and December 2014 at our center. Patient and graft survival at 3 years after RTx, frequencies of delayed graft function (DGF, need for dialysis < 1 week post RTx) and biopsy-proven acute rejections (AR) within the first year after RTx, 1-year glomerular filtration rate (eGFR, CKD-EPI) as well as surgical complications requiring reoperation or interventional treatment after RTx were assessed.

Of all 580 postmortal RTx, 416 (71.7%) were performed on weekdays (Monday-Friday) and 164 (28.3%) on weekends (Saturday-Sunday). 3-year patient survival, death-censored graft survival and overall graft survival were similar between weekend RTx and RTx performed on weekdays. Frequencies of DGF and biopsy-proven acute rejections within 1 year after RTx as well as 1-year eGFR were not different between both groups. Surgical complications requiring reoperation or interventional treatment occurred more often after RTx performed on weekends, mostly concerning vascular or ureteral problems. Length of hospital stay was not different after weekday and weekend RTx. All results remained consistent across all definitions of weekend status (Friday-Saturday or Sunday-Monday).

In our cohort, we did not observe a weekend effect on neither short-term nor long-term outcome parameters after RTx. The only difference noted was a higher rate of surgical complications after weekend RTx, which, however, did not affect the patient and transplant outcome. Substantiated by the comparable lengths of hospital stay in both groups, these findings suggest that work processes and medical performance in RTx on weekends are as efficient and professional as on working days. The standardized protocols and operationalized processes in centers routinely performing RTx might contribute to this finding and may provide a model for other medical procedures that are performed on weekends to improve efficiency and outcomes.

CITATION INFORMATION: Schütte-Nütgen K, Thölking G, Pavenstädt H, Suwelack B, Reuter S. Is There a [bdquo]Weekend Effect“ in Kidney Transplantation? – A Single Center Study. Am J Transplant. 2017;17 (suppl 3).

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