Background: Kidney transplant (KT) recipients with early hospital readmission (EHR, <30 days after discharge from KT) are at higher risk for poor post-KT outcomes. There are limited data on the impact of discharge during the weekend, a potentially vulnerable period for care transitions, on the risk of EHR after KT.

Methods: In this retrospective cohort of adult (>18 years) deceased donor KT recipients transplanted between 4/2010 and 11/2013 at five US centers, we examined the association of weekend discharge (Saturday or Sunday) after KT with subsequent EHR. We fit multivariable Cox models for the outcome of time-to-first EHR after KT, with adjustment for traditional recipient, donor, and allograft risk factors.

Results: 468 KT recipients were included in the analysis, 23% were discharged on a weekend day, and 38% experienced EHR after KT. Weekend and weekday discharges had similar demographics, comorbidities, and donor characteristics. Compared to weekday discharges, weekend discharges more frequently had an initial length of stay <4 days (65% vs 53%, p=0.03), less delayed graft function (28% vs 42%, p=0.007), and a lower EHR rate (28% vs 41%, p=0.02). Via multivariable analysis, KT recipients discharged during the weekend were 38% less likely to experience EHR (adjusted Hazard Ratio 0.62, 95% Confidence Interval: 0.41-0.94) than those discharged on weekdays. Our results were robust after adjustment for potential center effects.Conclusions: In this multi-center study, EHR after KT was a frequent event, but less common among those discharged on the weekend. Future studies are needed to identify factors that promote optimal discharge conditions for recipients of KT.

CITATION INFORMATION: Harhay M, Jia Y, Thiessen Philbrook H, Besharatian B, Gumber R, Weng F, Hall I, Doshi M, Schroeppel B, Parikh C, Reese P. Weekend Discharge and Early Hospital Readmission After Kidney Transplant: A Multi-Center Analysis. Am J Transplant. 2017;17 (suppl 3).

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