Background: Early hospital readmission (EHR) is associated with increased morbidity and mortality after kidney transplantation. However, following simultaneous pancreas-kidney transplantation (SPK), EHR rates are unknown, and it is unclear what recipient, transplant, and donor factors are associated with EHR.

Methods: We used USRDS and SRTR data to study 2,925 adult, first-time SPK recipients from January 1, 2000- November 1, 2011. EHR was any hospitalization within 30 days of initial transplant discharge. Modified Poisson regression was used to determine the association between EHR and 17 recipient, 5 transplant, and 4 donor factors.

Results: Across all transplant centers, the average EHR was 54.9% (IQR 47.8- 63.6%). EHR was associated with age such that each 5-year increase was associated with 4% lower risk of EHR up to age 45, beyond which there was no additional association. African-American (AA) and low-BMI recipients were at a higher risk of EHR (11% and 23% higher). Current smokers were at 13% higher risk of EHR. An AA donor was associated with a 27% higher risk of EHR. Length of stay was associated with EHR such that each one day increase was associated with 2% lower risk of EHR until 10 days, beyond which each day increase was associated with 1% lower risk of EHR.

Conclusions: EHR occurs in over half of SPK recipients and is associated with a number of patient-level risk factors and center-level variation. Identifying recipients at risk may help improve discharge planning and outpatient monitoring.

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