Year: 2024
Type: article
Study design: Observational Study
Abstract: Aims: We examined post-transplantation health service use for deceased donor kidney transplant recipients by donor type.Background: Use of extended criteria donors (ECDs) has increased availability of deceased donor kidneys, however evidence is limited regarding post-transplant healthcare utilisation.Methods: We used linked data from NSW Biovigilance Register (SAFEBOD) for all first kidney transplant recipients 2006-2019.Length of stay (LOS) and readmission for ECD, standard criteria donors (SCD) and donation after circulatory death (DCD) recipients were compared using Kruskal-Wallis Test.Results: We included 1373 donor-recipients; 553 (40.3%)SCDs, 423 (30.8%)ECDs, and 397 (28.9%)DCDs.Mean KDPI was 39.8%, 84.2%, and 62.7% respectively.SCD recipients experienced shorter post-transplant hospital stay: median 8 days (IQI: 6-13) compared to ECD (median:9 days, IQR:7-13) and DCD recipients (median:10, IQI:7-15, p < 0.001).Readmission rate within 6 weeks posttransplant was 56.6% for SCD, 59.8% for ECD, and 66.8% for DCD recipients ( p = 0.01).After ureteric stent removal, next most common primary procedure at first readmission were kidney biopsy and haemodyalsis for SCD (13.7% and 9.0% respectively) and ECD (19.1% and 11.1% respectively) recipients, and haemodialysis and kidney biopsy (24.2% and 9.1% respectively) for DCD recipients.Mean haemodialysis visits 1-year post-transplant was 1.4 for SCD, 3.4 for ECD, and 2.2 for DCD recipients.Median 1-year readmission count was 2 (IQI:1-4) for SCD, 3 (IQI:1-6) for ECD, and 3 (IQI:2-5) for DCD recipients ( p < 0.01).Conclusion: ECD had higher post-transplantation healthcare resource utilisation, longer post-transplantation LOS and increased 6-week readmission than SCD recipients.ECD had lower LOS and 6-week readmission rate but similar 1-year readmission counts than DCD recipients.Further investigation will adjust for patient/clinical characteristics and impact of ECD on outcomes like delayed graft function.
Source: Nephrology
DOI: 10.1111/nep.14360
Language: English
Subfield: Transplantation
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4401870556