INTRODUCTION: Patients awaiting kidney transplantation are at an increased risk of cholelithiasis and cholecystitis secondary to physiologic changes related to renal failure. Previous studies of cholecystectomy in patients with ESRD have been limited to small, single center studies. We studied outcomes of ESRD patients following cholecystectomy in both transplant and non-transplant centers nationwide.

METHODS: We used the Nationwide Inpatient Sample to study 40,765 ESRD and 5.4 million non-ESRD patients who underwent cholecystectomy (2000-2011). Mortality, complication rates, length of stay (LOS), and costs were compared using hierarchical logistic, negative binomial, and log-linear models respectively.

RESULTS: ESRD patients had higher mortality (5.0 vs 0.7% p<0.001, adjusted OR 4.03, 95% CI 3.08–5.26) and postoperative complication rates (23.1 vs 12.8% p<0.001, adjusted OR 2.42, 95% CI 2.09–2.81) than non-ESRD patients (table 1, 2). They were at a greater risk of infectious (OR 2.98 95% CI 2.68–3.32), mechanical wound (OR 2.21 95% CI 1.82–2.69), and intraoperative complications (OR 1.53 95% CI 1.32–1.78) (table 2). LOS was longer (8 vs 3 days p<0.001, ratio 1.48 95% CI 1.45–1.50) and costs were higher in ESRD patients ($17169 vs $8762, p<0.001, ratio 1.36 95% CI 1.34–1.39) (table 1, 2). Outcomes were similar by center type, except for longer LOS (p<0.001) and higher costs (p=0.002) at transplant centers.

CONCLUSIONS: ESRD patients experience higher mortality, complication rates, longer LOS and higher costs following cholecystectomy when compared to non-ESRD patients. Interventions targeting control of postoperative wound and infectious complications may allow for improvement in overall outcomes in KT candidates following cholecystectomy

CITATION INFORMATION: Olorundare I, DiBrito S, Holscher C, Garonzik-Wang J, Segev D. Outcomes After Cholecystectomy in Patients with End Stage Renal Disease. Am J Transplant. 2017;17 (suppl 3).

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