Introduction: Readmission rates for kidney transplant recipients is high and widely variable with a range of 18-47% nationwide. We aimed to characterize kidney transplant patients at our institution that were readmitted within 30 days of initial discharge.

Methods: Data encompassing demographics, donor type, and readmission were retrospectively reviewed for 300 kidney transplant recipients from 1/2015-4/2017. Simultaneous organ transplants were excluded. Data were analyzed with chi-squared, 2-tailed t-test, or Mann-Whitney U test.

Results: There were 71 patients readmitted (23.7%). Of the entire group, living donor recipients comprised 51% and deceased donor 49%. Deceased donor recipients had a trend towards higher rate of readmission (27% vs. 20%) (p=0.177). Among pre-transplant variables including sex, age, race and BMI, African-American (AA) recipients (23% of the study group) trended towards the highest rate of readmission at 34% compared to non-AA recipients (21% white and 20% other races [p=0.058]). There were 122 females (40.7%) and 178 males (59.3%) with no correlation between sex and readmission (p=0.387). Mean BMI at transplant was 24.3 (SD 5.1) and did not correlate with readmission (p= 0.436). Pre-transplant diabetes, but not type of diabetes, correlated with a higher readmission rate (35% versus 20% [p=0.006]). 38% of patients were readmitted with medical diagnoses comprising metabolic derangements, chronic anemia, dehydration, GI and cardiopulmonary diagnoses. 21% were readmitted with surgical complications, 13% with acute anemia, 21% with infection (predominately urinary tract), 6% with rejection and 1 patient was readmitted for reasons unrelated to transplant. A median of 1 phone call was made per patient prior to readmission (total 0-7 calls per patient), of which 48% were related to their readmission diagnosis.

Conclusions: At our institution, a diagnosis of diabetes was significantly correlated with higher 30-day readmission rates. Recipients of deceased donors and AA patients had higher rates of readmission, but the differences did not reach statistical significance. Regarding diagnosis, while infection and surgical complications were significant drivers of readmission as expected, the largest portion of our cohort presented with medical etiologies. Our result may assist transplant programs in developing targeted interventions to prevent readmissions.

CITATION INFORMATION: Crane A., Eltemamy M., Jacobsen D., Coy T., Sun A., Babbar P., Ponziano M., Poggio E., Wee A., Fatica R., Krishnamurthi V. Predictors of Kidney Transplant Recipient Readmissions Am J Transplant. 2017;17 (suppl 3).

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