BACKGROUND: Among first time kideny transplant (KT) recipients the incidence of early hospital readmission (EHR) is 31%. Kidney re-transplants are more complex and we hypothesize that these receipients have a higher incidence of EHR, although this has never been studied.

METHODS: We used USRDS data to study 70,852 adult Medicare primary kidney transplant recipients. EHR was any hospitalization within 30 days of initial transplant discharge. Modified Poisson regression was used to determine the association between re-transplantation and EHR, adjusting for patient-level risk factors. Empirical Bayes estimation was used to explore variation in readmission of re-transplant recipients by center.

RESULTS: Among the 70,852 KTs, 9,132 (12.9%) were re-transplants. The crude incidence of EHR among re-transplant recipients was 35.7%, which is higher than the 31.7% incidence among first time recipients (p<0.001). In an adjusted model, re-transplantation was associated with a 22% higher risk of EHR (aRR 1.22, 95% CI 1.18-1.26, p<0.001). In a subgroup analysis of re-transplant recipients, several factors increase the risk of EHR, including African American race, hypertension, dialysis vintage, extended criteria donor, DCD donor, and prolonged length of stay. Empirical Bayes estimation demonstrated significant variation in the incidence of EHR across centers after adjusting for patient-level characteristics.

CONCLUSIONS: Early hospital readmission occurs more frequently following re-transplantation than first time KT. Few patient-level characteristics predict EHR among re-transplant recipients. The higher rate of EHR may be secondary to the increased operative and clinical complexity of re-transplantation.

CITATION INFORMATION: King E, Orandi B, Bae S, Luo X, Segev D. Early Hospital Readmission Following Kidney Re-Transplantation. Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress