Background: Early hospital readmission occurs in 31% of kidney transplant (KT) recipients and may be associated with mechanistic factors not previously captured in patient-level risk models. The aim of this study was to determine the association between EHR and distance of the recipient from the transplant center.

Methods: USRDS and SRTR data were linked for adult, kidney-only transplant recipients from January 2005 through November 2011. EHR was any readmission within 30 days of initial discharge following KT. Logistic regression, adjusted for patient-level factors (age, sex, race, BMI, diabetes, hypertension, ischemic heart disease, congestive heart failure, arrhythmia, cancer, smoking, dialysis vintage, donor age, donor-type, length of stay, induction, and hla mismatch), was used to determine the association between EHR and distance from recipient home to transplant center (based on zip code).

Results: The average distance from recipient home to transplant center was shorter for readmitted recipients compared to recipients that were not readmitted (42.0 miles compared to 45.7 miles, p < 0.001). KT recipients that lived within 10 miles of their transplant center had increased odds of EHR compared to those living more than 10 miles from the transplant center (aOR 1.12, 95% CI 1.07-1.17, p < 0.001).

Conclusions: Ironically, recipients that live near their transplant center are more likely to be readmitted following KT. It might stand to reason that recipients living nearby could easily come to clinic for evaluation and return home if appropriate. A system which allows medical evaluation prior to readmission may help decrease EHR.

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