Division of Transplant Surgery, Mayo Clinic, Phoenix, Arizona.
Mayo Clinic Alix School of Medicine, Scottsdale, Arizona.
Transplant Proc. 2024 Sep;56(7):1545-1551. doi: 10.1016/j.transproceed.2024.08.003. Epub 2024 Aug 22.
Delayed graft function (DGF) is a common post-transplant event associated with increased resource utilization. As a center with experience in DGF, we aimed to assess differences in readmissions and post-transplant outcomes between patients with and without DGF.
This was a retrospective review of deceased donor kidney transplant recipients at Mayo Clinic Arizona between 2015 and 2020. Recipients with at least one early readmission following kidney transplantation were included in the study. Two groups were identified: (1) recipients with DGF who required early readmission and (2) recipients without DGF who required early readmission.
Among recipients with DGF, 43.9% (n = 405) required early readmission compared to 29.1% (n = 179) without DGF (P < .0001). There were no differences in the initial hospital length of stay (P = .08), and most recipients in both groups only required a single readmission (61.7% vs 72.1%, P = .02). Recipients with DGF were more likely to have ≥2 readmissions (P = .02) and a higher total readmission rate (P = .006). Recipients with DGF who required readmission also required more outpatient clinic visits (P = .003). When comparing recipients with and without DGF who required readmission, there were no differences in patient (P = .22) or death-censored (P = .72) graft survival. When comparing patients with and without DGF requiring one versus ≥2 readmissions, there were no differences in patient survival (P = .15), however patients with DGF and ≥2 readmissions had lower death-censored graft survival (P = .001).
Recipients with DGF are at increased risk of readmission. Transplant center-level changes to reduce readmissions and infections could have an important impact on DGF outcomes.
延迟移植物功能（DGF）是一种常见的移植后事件，与资源利用增加有关。作为一个有 DGF 经验的中心，我们旨在评估 DGF 患者与非 DGF 患者在再入院和移植后结局方面的差异。
这是对 2015 年至 2020 年间在亚利桑那州梅奥诊所接受已故供体肾移植的患者进行的回顾性研究。研究纳入了至少一次早期肾移植后再入院的患者。确定了两个组：（1）需要早期再入院且有 DGF 的患者；（2）需要早期再入院且无 DGF 的患者。
在有 DGF 的患者中，43.9%（n = 405）需要早期再入院，而无 DGF 的患者中为 29.1%（n = 179）（P <.0001）。两组初始住院时间无差异（P =.08），且大多数患者仅需单次再入院（61.7% vs 72.1%，P =.02）。有 DGF 的患者更有可能有≥2 次再入院（P =.02）和更高的总再入院率（P =.006）。需要再入院的 DGF 患者需要更多的门诊就诊次数（P =.003）。在比较需要再入院且有和无 DGF 的患者时，在患者（P =.22）或死亡风险调整（P =.72）移植物存活率方面无差异。在比较需要再入院且有和无 DGF 的患者中，有 1 次和≥2 次再入院的患者在患者生存率方面无差异（P =.15），但有 DGF 和≥2 次再入院的患者死亡风险调整移植物存活率较低（P =.001）。
有 DGF 的患者再入院风险增加。减少再入院和感染的移植中心层面的改变可能对 DGF 结局有重要影响。
