Background:Renal transplantationhas become increasingly more prevalent in geriatric populations. To optimize outcomes, renal transplant patients must be compliant with post-operative medication useand clinic follow up. Older adulttransplant recipients may face compliance challenges that can potentially lead to hospital readmission. As part of a co-management pilot program between geriatrics and renal transplant teams, this study examined whether geriatric syndromes such as functional impairment or memory problem affect the risk of readmission after renal transplantation.

Methods: Retrospective chart review was conducted on ninety-nine patients aged 65 or older who underwent renal transplantation in the period of 7/30/2013 to 8/10/2016 at a major academic hospital in New York. Extracted data included general demographics, ED visits and readmissions within one year after the transplant, readmission diagnoses, need for ADL assistance at the time of transplantation, notation of any memory problem in their medical records, in-hospital occurrences of delirium.

Results: The average recipient age was 69.8. 1-year-postoperative survival rate was 95.8%. Graft failure occurred in 1 case within one year. Among the 99 patients, 94 had formal ADL assessments by physical therapists or social workers, with 12requiringADL assistance.Eight of 99 patients had notations of memory problems in their medical record. All 20 patients with either functional dependence or memory issues were readmitted to the hospital within one year of transplantation. The most common admitting diagnoses were urinary tract infection for the functionally dependent group andhyperkalemia for the patients with memory problems. In-hospital episodes of delirium occurred more frequently in the eight patients with documented memory problems. (RR 3.1, p=0.048)

Conclusion: Functional impairment and cognitive dysfunction in geriatric renal transplant recipients were associated with significantly increased risk of at least onehospital readmission within one year of transplantation (RR 1.86, p<0.01 and RR 1.86, p=0.01, respectively).Further investigation by the co-management team will examine how to prevent readmissions in functionally or cognitively impaired geriatric renal transplantation patients.

CITATION INFORMATION: Uemura T., Rodriguez V., Rosen G., Lerner S., Apoeso O. Effect of Functional and Cognitive Impairment on Readmissions in Geriatric Renal Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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