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The Opioid Strikes Back: Pre-Transplant Opioid Exposure is Associated with Increased Readmissions after Renal Transplant

B. O'Brien, N. Patel, L. Wilson, P. Mauldin, S. Ball, R. Gilbert, Z. Elmaasarani, P. Baliga, N. Pilch, D. Taber, J. Fleming.

Medical University of South Carolina, Charleston, SC.

Meeting: 2018 American Transplant Congress

Abstract number: A307

Keywords: Kidney transplantation, Post-operative complications

Session Information

Date: Saturday, June 2, 2018

Session Name: Poster Session A: Non-Organ Specific: Disparities to Outcome and Access to Healthcare

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall 4EF

Related Abstracts
  • The Financial Impact of the Opioid Epidemic on Kidney Transplantation Readmissions
  • Risk Factors for Chronic Opioid Use after Kidney Transplantation

Recent analyses suggest that opioid use in renal transplant recipients is associated with increased complications, graft loss and mortality. The aim of this study was to determine the impact of opioid exposure on hospital readmission rates in renal transplant recipients.

Methods: This was a retrospective cohort analysis of renal transplant recipients from Jan 2010 – Dec 2016. Data was collected via chart review and a pharmaceutical claims database. Patients reporting active opioid use during medication reconciliation or with an opioid prescription filled in the 3 months prior to transplant were classified as opioid experienced. Variables were analyzed to determine the association of opioid use on 30-day, 90-day, and 1-year readmission rates. With this data, a predictive model was created using binary logistic regression with backwards elimination.

Results: This study included 1129 patients, 24% of which were classified as opioid experienced. Opioid experienced patients were more likely to be Caucasian, highly sensitized, have concomitant benzodiazepine use, and experience DGF (Table 1). There were significantly higher readmission rates at 30-day, 90-day, and 1-year in patients with prior opioid exposure (Figure 1, Table 2) and opioid use was found to be independently predictive of 1-year readmissions (Table 3). Indications for readmission were similar between both groups, with infections as the leading cause followed by surgical complications (Figure 2). However, no difference was found in preventability of readmissions (Table 4).

Conclusions: Opioid use prior to renal transplant is associated with readmissions at all time points post-transplant and is a significant predictor of 1-year readmissions.

CITATION INFORMATION: O'Brien B., Patel N., Wilson L., Mauldin P., Ball S., Gilbert R., Elmaasarani Z., Baliga P., Pilch N., Taber D., Fleming J. The Opioid Strikes Back: Pre-Transplant Opioid Exposure is Associated with Increased Readmissions after Renal Transplant Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

O'Brien B, Patel N, Wilson L, Mauldin P, Ball S, Gilbert R, Elmaasarani Z, Baliga P, Pilch N, Taber D, Fleming J. The Opioid Strikes Back: Pre-Transplant Opioid Exposure is Associated with Increased Readmissions after Renal Transplant [abstract]. https://atcmeetingabstracts.com/abstract/the-opioid-strikes-back-pre-transplant-opioid-exposure-is-associated-with-increased-readmissions-after-renal-transplant/. Accessed February 27, 2021.

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