Hospitalization costs and their determining factors among patients undergoing kidney transplantation: a cross-sectional descriptive study

Background In the Eurotransplant, 12.6% of kidney transplantations are a repeat procedure. Third transplants are significantly more complex than first and second ones. We compared the results of first (PRT) versus third (TRT) transplantations. Methods Between 2011 and 2016, we performed 779 deceased donor adult kidney transplantations, 14.2% out of them were second, 2.6% (20) third, and 0.3% fourth. We compared the pre-, intra-, and postoperative data, kidney function, and survival rate. Results Recipients of TRT were younger (53.4 vs. 47.3 p = 0.02). HCV infection rate (20%, p = 0.00) is ten times higher. The operation time is longer (132 vs. 152 min, p = 0.02), and delayed graft function is much more frequent (22.4% vs. 60%, p = 0.00). Induction therapy was given to every TRT (7.9% vs.100%), but as a result, the rejection rate was the same (~ 15%). Hospital stay is a week longer. Patient’s survival at 1, 3, and 5 years for PRT is 96.4%, 93.9%, and 91.2% and for TRT is 90%, 85%, and 78.4%, respectively (p = 0.023). TRT’s odds ratio of fatal outcome is 4.35 (1.5–12.5). Graft survival at 1, 3, and 5 years for PRT is 93.1%, 91.4%, and 90.3% and for TRT is 75%, 75%, and 75%, respectively (p = 0.020). TRT’s odds ratio of graft loss is 3.14 (1.1–8.9). Of PRT 85.76%, out of PRT 85.76%, while out of TRT 60% live with a functioning graft, p=0.00149. Conclusion In a third transplant, both graft and patient survival are significantly inferior to primer ones. Careful selection is required to minimize the patient risk and graft loss.

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“…All these factors together count for much higher expenses in case of a third transplantation [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of first versus third kidney transplantations: propensity score matching and paired subgroup analysis—a single-centre experience

Telkes

Piros

Szabó

et al. 2021

Langenbecks Arch Surg

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“…Currently no reliable index or measure used to accurately predict prolonged hospital stay in children following KT. Since LOS is a key determining factor of cost [11] and can predict poor graft and patient survival, especially when prolonged longer than two weeks [12], a risk factor score or equivalent for children is vital for optimizing outcomes in pediatric KT.…”

Section: Introductionmentioning

confidence: 99%

A novel risk score for predicting prolonged length of stay following pediatric kidney transplant

DiLeo

Miggins

Brewer

et al. 2023

Preprint

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Background Kidney transplants (KT) are accepted as the kidney replacement therapy of choice for children with kidney failure. The surgery itself may be more difficult especially in small children, and often leads to significant hospital stays. There is little research for predicting prolonged length of stay (LOS) in children. We aim to examine the factors associated with prolonged LOS following pediatric KT to help clinicians make informed decisions, better counsel families, and potentially reduce preventable causes of prolonged stay. Methods We retrospectively analyzed the United Network for Organ Sharing database for all KT recipients less than 18-years-old between January 2014 and July 2022 (n = 3,693). Donor and recipient factors were tested in univariate and multivariate logistic analysis using stepwise elimination of non-significant factors to create a final regression model predicting LOS longer than 14 days. Values were assigned to significant factors to create risk scores for each individual patient. Results In the final model, only primary diagnosis of focal segmental glomerulosclerosis, dialysis prior to KT, geographic region, and recipient weight prior to KT were significant predictors of LOS longer than 14 days. The C-statistic of the model is 0.7308. The C-statistic of the risk score is 0.7221. Conclusions Knowledge of the risk factors affecting prolonged LOS following pediatric KT can help identify patients at risk of increased resource use and potential hospital-acquired complications. Using our index, we identified some of these specific risk factors and created a risk score that can stratify pediatric recipients into low, medium, or high-risk groups.

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A novel risk score for predicting prolonged length of stay following pediatric kidney transplant

et al. 2023

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Hospitalization costs and their determining factors among patients undergoing kidney transplantation: a cross-sectional descriptive study

Cited by 3 publications

References 16 publications

Outcomes of first versus third kidney transplantations: propensity score matching and paired subgroup analysis—a single-centre experience

Outcomes of first versus third kidney transplantations: propensity score matching and paired subgroup analysis—a single-centre experience

A novel risk score for predicting prolonged length of stay following pediatric kidney transplant

A novel risk score for predicting prolonged length of stay following pediatric kidney transplant

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