Previously, we demonstrated that ECD kidney recipients had an increased rate of re-hospitalization within 1 year but not 2 years post-transplant . This was a retrospective review of all adult first-time transplants receiving deceased donor kidneys (381 SCD and 164 ECD) from 2003-2012 at our center. To further characterize this association, we analyzed the causes of re-hospitalization within the first year after transplant. There were 904 re-hospitalizations in total (567 SCD and 337 ECD). Cause of re-hospitalization was determined via review of the ICD-9 diagnosis code. Each code was categorized using the Clinical Classification System created by the Healthcare Cost and Utilization Project(1). The greatest proportion of re-hospitalizations within each age group was due to “Injury” with 151 re-admissions (26.6%) in the SCD group and 109 re-admissions (32.3%) in the ECD group. This category included all surgical complications. The second most common category was “Diseases of the Circulatory System”, followed by “Endocrine, nutritional, metabolic diseases, and immunity disorders”.

Our results suggest that although ECD recipients are re-hospitalized more, causes of re-admissions between ECD and SCD recipients are not markedly different. The categories of “Injury” and “Diseases of the Circulatory System” vary the most between ECD recipients and SCD recipients. Readmission prevention strategies should be tailored to pathologies within these categories.

1. http://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp.

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