Mıhçıokur Sare, Doğan Gülser, Kocalar Gülsüm, Erdal Rengin, Haberal Mehmet
From the Department of Public Health, Baskent University, Ankara, Turkey.
Exp Clin Transplant. 2019 Jan;17(Suppl 1):264-269. doi: 10.6002/ect.MESOT2018.P120.
In our country, there are few publications evaluating emergency department visits among kidney, liver, and heart transplant recipients. Here, we examined emergency department visits of transplant recipients after initial hospital discharge following organ transplant performed in a medical faculty hospital in Ankara, Turkey.
We retrospectively analyzed hospital records of 1144 transplant recipients (700 kidney, 332 liver, and 112 heart) who underwent living-donor and deceased-donor organ transplant procedures in a university hospital between 2007 and 2017 and were admitted to the emergency department during the same period.
The study population (1144 organ transplants) consisted of kidney (61.2%), liver (29.0%), and heart (9.8%) transplant recipients. Among them, 67.9% of kidney transplant recipients and 62.0% of liver transplant recipients were male, whereas 65.2% of heart transplant recipients were female. Average ages were 32.8 ± 15.5, 24.26 ± 21.6, and 29.9 ± 18.7 years, respectively. Among all groups, 41.4% visited the emergency department within 2 years after transplant. Median time to emergency department visit for kidney, liver, and heart transplant recipients was 4.7 months, 3.5 months, and 11.5 months, respectively. Emergency department admissions were due to complaints of abdominal/pelvic pain, fever, nausea/vomiting, hypertension, and nonspecific chest pain. Among all groups, the main diagnoses were most commonly classified by fluid and electrolyte disorders, abnormal results of renal function, urinary tract infections, and acute respiratory infections. One-third of patients were hospitalized.
Nearly one-quarter of kidney transplant recipients, one-fifth of liver transplant recipients, and one-tenth of heart transplant recipients visited the emergency department within 30 days of transplantation. Considering that one-third were rehospitalized, the recipients could be targeted for better transitions of care and for earlier or more frequent outpatient follow-up and also be informed about what symptoms are not normal and in which situations they should seek emergency care.
在我国，评估肾、肝和心脏移植受者急诊就诊情况的出版物较少。在此，我们调查了在土耳其安卡拉一家医学院附属医院接受器官移植后首次出院的移植受者的急诊就诊情况。
我们回顾性分析了2007年至2017年期间在一所大学医院接受活体供体和尸体供体器官移植手术且同期入住急诊科的1144例移植受者（700例肾移植、332例肝移植和112例心脏移植）的医院记录。
研究人群（1144例器官移植）包括肾移植受者（61.2%）、肝移植受者（29.0%）和心脏移植受者（9.8%）。其中，67.9%的肾移植受者和62.0%的肝移植受者为男性，而65.2%的心脏移植受者为女性。平均年龄分别为32.8±15.5岁、24.26±21.6岁和29.9±18.7岁。在所有组中，41.4%的患者在移植后2年内就诊于急诊科。肾、肝和心脏移植受者急诊就诊的中位时间分别为4.7个月、3.5个月和11.5个月。急诊入院原因包括腹部/盆腔疼痛、发热、恶心/呕吐、高血压和非特异性胸痛。在所有组中，主要诊断最常见的分类为液体和电解质紊乱、肾功能异常结果、尿路感染和急性呼吸道感染。三分之一的患者住院治疗。
近四分之一的肾移植受者、五分之一的肝移植受者和十分之一的心脏移植受者在移植后30天内就诊于急诊科。考虑到三分之一的患者再次住院，可针对受者进行更好的护理过渡以及更早或更频繁的门诊随访，并告知他们哪些症状不正常以及在哪些情况下应寻求急诊护理。
