A nationwide analysis of re-operation after kidney transplant

Abstract

Introduction: We aimed to report the rate and short-term outcomes of patients undergoing reoperation following kidney transplant in the U.S. Methods: The ationwide Inpatient Sample (NIS) database was used to examine the clinical data of patients undergoing kidney transplant and reoperation during same the hospitalization from 2002-2012. Multivariate regression analysis was performed to compare outcomes of patients with and without re-operation. Results: We sampled a total of 35 058 patients who underwent kidney transplant. Of these, 770 (2.2%) had re-operation during the same hospitalization. Re-operation was associated with a significant increase in mortality (30.4% vs. 3%; adjusted odds ratio [AOR] 4.62; p<0.01), mean total hospital charges ($249 425 vs. $145 403; p<0.01), and mean hospitalization length of patients (18 vs. 7 days, p<0.01). The most common day of re-operation was POD 1. Hemorrhagic complication (64.2%) was the most common reason for re-operation, followed by urinary tract complications (9.9%) and vascular complications (3.6%). Preoperative coagulopathy (AOR 3.35; p<0.01) was the strongest predictor of need for re-operation, hemorrhagic complications (AOR 3.08; p<0.01), and vascular complications (AOR 2.50; p<0.01). Also, hypertension (AOR 1.26; p<0.01) and peripheral vascular disorders (AOR 1.25; p=0.03) had associations with hemorrhagic complications. Conclusions: Re-operation after kidney transplant most commonly occurs on postoperative Day 1 and occurs in 2.2% of cases. It is associated with significantly increased mortality, hospitalization length, and total hospital charges. Hemorrhage is the most common complication.

Exploration of wound‐related complications post‐kidney transplantation

“…Woundrelated complications continue to pose a substantial postoperative challenge, notwithstanding the progress made in surgical techniques and postoperative care. 3,4 These complications place significant strain on healthcare resources and endanger the health of patients. [5][6][7] Complicated wound conditions post-kidney transplant complications are the substantial issue within domain of the transplant medicine, exerting influence on healthcare resources and patient outcomes.…”

“…Kidney transplants, being the most efficacious intervention for renal failure, have experienced a surge in global prevalence. Wound‐related complications continue to pose a substantial postoperative challenge, notwithstanding the progress made in surgical techniques and postoperative care 3,4 . These complications place significant strain on healthcare resources and endanger the health of patients 5–7 …”

“…Wound‐related complications continue to pose a substantial postoperative challenge, notwithstanding the progress made in surgical techniques and postoperative care. 3 , 4 These complications place significant strain on healthcare resources and endanger the health of patients. 5 , 6 , 7 …”