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Significant Implications of Prior Transplantation on Treatment and Outcomes of Patients Suffering from Traumatic Brain Injury

L. Mugge, W. Qu, C. Gallagher, A. Caras, N. Henkel, O. Ekwenna, J. Ortiz

The University of Toledo Medical Center, Toledo, OH

Meeting: 2019 American Transplant Congress

Abstract number: C359

Keywords: Adverse effects, Brain death, Surgical complications, Survival

Session Information

Session Name: Poster Session C: Surgical Issues: All Organs

Session Type: Poster Session

Date: Monday, June 3, 2019

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Recent events in the media and sporting industry highlight traumatic brain injury (TBI) as a major health concern, having implications in many areas of medicine. Given the limited knowledge concerning disease process and treatment of TBI, there is a need for studies which examine contributing factors. We examined patients who suffered from TBI and also have a history of renal transplantation.

*Methods: The National Inpatient Sample database of Healthcare Cost and Utility Project between 2008 and 2014 was used. Patients with a diagnosis of TBI were identified and divided into those with a history of transplantation (HTx) and non-transplant recipients (No-HTx). These were compared for differences in demographics, complications, and other factors related to their care.

*Results: 209,250 patients met inclusion criteria with 1,240 (0.6%) having a prior history of transplantation. HTx were more likely to be older and to demonstrate a higher in-hospital mortality index score (71.3 vs 64.1, p<.001 and 8 vs 0, p<.001, respectively). For severity, HTx were less likely to have lost consciousness and to require ventriculostomy placement (53.2% vs 41.1%, p<.001 and 1.4% vs 2.5%, p=0.012, respectively). However, HTx were more likely to suffer a seizure and require red blood cell (RBC) transfusion during their hospital stay (6.94% vs 5.58%, p=0.039 and 12.10% vs 8.12%, p<.001, respectively). Finally, HTx patients were more likely to have a longer in-hospital stay (5 vs 4 days, p=.001), require transfer to a skilled nursing facility (40.4% vs 35.8%, p=.001), and need home-health care (13.5% vs 9.6%, p<.001).

*Conclusions: While HTx patients unsurprisingly have higher in-hospital mortality index score, differences in specific central nervous system complications, namely incidence of seizure, and necessary intra-cranial interventions, such as ventriculostomy placement, suggests the possibility that the pathological process is different between transplant and non-transplant recipients. Given that a history of transplantation seems to have implications for care of patients with TBI, additional studies are needed to investigate a potential relationship between the pathological processes that necessitate renal transplantation and the pathophysiology of TBI.

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To cite this abstract in AMA style:

Mugge L, Qu W, Gallagher C, Caras A, Henkel N, Ekwenna O, Ortiz J. Significant Implications of Prior Transplantation on Treatment and Outcomes of Patients Suffering from Traumatic Brain Injury [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/significant-implications-of-prior-transplantation-on-treatment-and-outcomes-of-patients-suffering-from-traumatic-brain-injury/. Accessed June 1, 2025.

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