Hospital Readmission Following Pediatric Heart Transplantation

Rehospitalization Following Pediatric Heart Transplantation: Incidence, Indications, and Risk Factors

“…This may be partially explained by the inclusion of observation admissions, which accounted for 6.5% of the rehospitalization rate in our analysis. However, recently published data from the Clinical Trials in Organ Transplantation for Children (CTOTC-04) collaborative have reported a similarly high rate of readmission, 56.8%, in the first year following HT [10]. Approximately half of all rehospitalizations in our study occurred early, within 30 days of transplant admission discharge, a finding corroborated by the 29.5% early readmission rate reported by Mahle et al [10].…”

“…This finding is unsurprising given the immunosuppressed state of heart transplant recipients early after transplant and the subsequent increased risk for infection, as well as the common nature of viral infections in children. The findings of graft rejection and infection as the most common causes of post-transplant hospital readmissions have been demonstrated following pediatric solid organ transplant and in adult HT recipients [4,9,10,13]. Among rehospitalizations, admission to the ICU was less common, with the utilization of ECMO or mechanical ventilation rarer still, findings that were similar to those reported by Hollander et al [9].…”

“…Patients with a pretransplant diagnosis of congenital heart disease are known to have increased morbidity and mortality following transplant, for which they may require more frequent hospitalization [1]. The association between a pretransplant listing status of 1B and rehospitalization following transplant is not readily explained; however, listing status other than 1A was also identified for a risk factor for readmission by Mahle et al [10] It is conceivable that this finding originates from the inferior posttransplant survival in patients listed status 1A, but also may indicate that current allocation system does not adequately quantify patient risk [17]. The risk factors identified in this study, derived from a diverse population of patients across many centers, should be more generalizable to the pediatric transplant population compared to prior studies.…”

“…In the pediatric HT population, readmission rates have been reported to be as high as 55-84% [9,10]. However, these data were derived from a small number of centers and therefore may not be generalizable to centers nationwide.…”