Dashti Sommiya, Dhrolia Murtaza, Nasir Kiran, Qureshi Ruqaya, Ahmad Aasim
Nephrology, The Kidney Centre Post Graduate Training Institute, Karachi, PAK.
Cureus. 2022 Feb 9;14(2):e22043. doi: 10.7759/cureus.22043. eCollection 2022 Feb.
Objective The aim of our study was to evaluate the incidence, causes, risk factors, outcomes, and cost of hospital readmission after live related renal transplantation (LRRT). Methods We conducted a cross-sectional study and followed patients' re-admissions for six months whose LRRT was done in our center between September 2019 and June 2020. Results We recruited 53 patients, 40 (75.5%) were male. The mean age was 36.9 ± 11.9 years. Donor gender was similar, and their mean age was 31.6 ± 9.2 years. The mean length of hospital stay after LRRT was 14 ± 2.2 days. A total of 81.1% were readmitted after LRRT within the first six months, with a total of 113 readmissions. The median time of readmission after LRRT was 66 days. The median readmission hospital stay was four days. The causes of readmission were surgical in 11 (9.7%), medical in 89 (78.8%), and combined medical and surgical in 13 (11.5%). Infection was the most common medical cause, followed by rejection. Statistically significant difference between readmission and non-readmission groups was found in estimated glomerular filtration rate (eGFR) at six month 61.3 ± 25.9 vs. 84.3 ± 36.1 mL/min/1.73 m respectively (p = 0.02). The median cost of readmission was PKR 40629, equivalent to USD 261. Conclusion Over three-fourths of the patients were readmitted after LRRT within the first six months. The most common causes were infection and rejection. Readmissions after LRRT are associated with lower graft function at six months and a significant cost burden on the health system.
目的 本研究旨在评估亲属活体肾移植（LRRT）后医院再入院的发生率、原因、危险因素、结局及费用。方法 我们进行了一项横断面研究，对2019年9月至2020年6月在本中心接受LRRT的患者进行了为期六个月的再入院随访。结果 我们招募了53例患者，其中40例（75.5%）为男性。平均年龄为36.9±11.9岁。供体性别相似，平均年龄为31.6±9.2岁。LRRT后平均住院时间为14±2.2天。共有81.1%的患者在LRRT后的前六个月内再次入院，共113次再入院。LRRT后再入院的中位时间为66天。再入院的中位住院时间为4天。再入院原因中，手术相关的有11例（9.7%），医疗相关的有89例（78.8%），医疗和手术合并相关的有13例（11.5%）。感染是最常见的医疗原因，其次是排斥反应。再入院组和未再入院组在六个月时的估计肾小球滤过率（eGFR）存在统计学显著差异，分别为61.3±25.9 vs. 84.3±36.1 mL/min/1.73 m²（p = 0.02）。再入院的中位费用为40629巴基斯坦卢比，相当于261美元。结论 超过四分之三的患者在LRRT后的前六个月内再次入院。最常见的原因是感染和排斥反应。LRRT后的再入院与六个月时较低的移植肾功能以及卫生系统的重大费用负担相关。
