Early hospital readmissions after ABO- or HLA- incompatible living donor kidney transplantation

Juhan Lee, Deok Gie Kim, Beom Seok Kim, Myoung Soo Kim, Soon Il Kim, YuSeun Kim, Kyu Ha Huh

Research output: Contribution to journalArticle

Abstract

Early hospital readmission (EHR) after kidney transplantation (KT) is associated with adverse outcomes and significant healthcare costs. Despite survival benefits, ABO- and HLA-incompatible (ABOi and HLAi) KTs require desensitization and potent immunosuppression that increase risk of EHR. However, little data exist regarding EHR after incompatible KT. We defined EHR as admission for any reason within 30 days of discharge from the index hospitalization. Patients who underwent living donor KT from 2010–2017 were classified into one of three groups (control, ABOi KT, or HLAi KT). Our study included 732 patients, 96 (13.1%) of who experienced EHR. HLAi KT patients had a significantly higher incidence of EHR than other groups (26.6%; P < 0.001). In addition, HLAi KT (HR, 2.26; 95% CI, 1.35–3.77; P = 0.002) and advanced age (≥60 years) (HR, 1.93; 95% CI, 1.20–3.12; P = 0.007) were independent risk factors for EHR. Patients with EHR showed 1.5 times and 3 times greater risk of late hospital readmission and death-censored graft loss, respectively, and consistently exhibited inferior renal function compared to those without EHR, regardless of immunologic incompatibilities. We recommend that KT recipients experiencing EHR or its risk factors be managed with extreme care due to their increased susceptibility to adverse outcomes.

Original languageEnglish
Article number3246
JournalScientific reports
Volume9
Issue number1
DOIs
Publication statusPublished - 2019 Dec 1

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Patient Readmission
Living Donors
Kidney Transplantation
Health Care Costs
Immunosuppression
Hospitalization

All Science Journal Classification (ASJC) codes

  • General

Cite this

Lee, Juhan ; Kim, Deok Gie ; Kim, Beom Seok ; Kim, Myoung Soo ; Il Kim, Soon ; Kim, YuSeun ; Huh, Kyu Ha. / Early hospital readmissions after ABO- or HLA- incompatible living donor kidney transplantation. In: Scientific reports. 2019 ; Vol. 9, No. 1.
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Early hospital readmissions after ABO- or HLA- incompatible living donor kidney transplantation. / Lee, Juhan; Kim, Deok Gie; Kim, Beom Seok; Kim, Myoung Soo; Il Kim, Soon; Kim, YuSeun; Huh, Kyu Ha.

In: Scientific reports, Vol. 9, No. 1, 3246, 01.12.2019.

Research output: Contribution to journalArticle

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