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Donor type and 3-month hospital readmission following kidney transplantation: results from the Netherlands organ transplant registry

Authors
  • Wang, Yiman1
  • Heemskerk, Martin B. A.2
  • Michels, Wieneke M.3, 3
  • de Vries, Aiko P. J.3, 3
  • Dekker, Friedo W.1
  • Meuleman, Yvette1
  • 1 Leiden University Medical Center, P.O. Box 9600, Leiden, 2300 RC, The Netherlands , Leiden (Netherlands)
  • 2 Dutch Transplant Foundation, Leiden, The Netherlands , Leiden (Netherlands)
  • 3 Leiden University Medical Center, Leiden, The Netherlands , Leiden (Netherlands)
Type
Published Article
Journal
BMC Nephrology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Apr 27, 2021
Volume
22
Issue
1
Identifiers
DOI: 10.1186/s12882-021-02363-5
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundHospital readmission after transplantation is common in kidney transplant recipients (KTRs). In this study, we aim to compare the risk of 3-month hospital readmission after kidney transplantation with different donor types in the overall population and in both young (< 65 years) and elderly (≥65 years) KTRs.MethodsWe included all first-time adult KTRs from 2016 to 2018 in the Netherlands Organ Transplant Registry. Multivariable logistic regression models were used to estimate the effect while adjusting for baseline confounders.ResultsAmong 1917 KTRs, 615 (32.1%) had at least one hospital readmission. Living donor kidney transplantation (LDKT) recipients had an adjusted OR of 0.76 (95%CI, 0.61 to 0.96; p = 0.02) for hospital readmission compared to deceased donor kidney transplantation (DDKT) recipients. In the young and elderly, the adjusted ORs were 0.69 (95%CI, 0.52 to 0.90, p = 0.01) and 0.93 (95%CI, 0.62 to 1.39, p = 0.73) and did not differ significantly from each other (p-value for interaction = 0.38). In DDKT, the risk of hospital readmission is similar between recipients with donation after cardiac death (DCD) or brain death (DBD) and the risk was similar between the young and elderly.ConclusionA lower risk of post-transplant 3-month hospital readmission was found in recipients after LDKT compared to DDKT, and this benefit of LDKT might be less dominant in elderly patients. In DDKT, having either DCD or DBD donors is not associated with post-transplant 3-month hospital readmission, regardless of age. Tailored patient management is needed for recipients with DDKT and elderly KTRs.

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