AUTHOR=Jadlowiec Caroline C. , Frasco Peter , Macdonough Elizabeth , Wagler Josiah , Das Devika , Budhiraja Pooja , Mathur Amit K. , Katariya Nitin , Reddy Kunam , Khamash Hasan , Heilman Raymond 

TITLE=Association of DGF and Early Readmissions on Outcomes Following Kidney Transplantation

JOURNAL=Transplant International

VOLUME=35

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10849

DOI=10.3389/ti.2022.10849

ISSN=1432-2277

ABSTRACT=<p>Concerns regarding outcomes and early resource utilization are potential deterrents to broader use of kidneys at risk for delayed graft function (DGF). We assessed outcomes specific to kidneys with DGF that required early readmission following transplant. Three groups were identified: 1) recipients with DGF not requiring readmission, 2) recipients with DGF having an isolated readmission, and 3) recipients with DGF requiring ≥2 readmissions. Most recipients either required a single readmission (26.8%, <italic>n</italic> = 247) or no readmission (56.1%, <italic>n</italic> = 517); 17.1% (<italic>n</italic> = 158), had ≥2 readmissions. Recipients requiring ≥2 readmissions were likely to be diabetic (53.8%, <italic>p</italic> = 0.04) and have longer dialysis vintage (<italic>p</italic> = 0.01). Duration of DGF was longer with increasing number of readmissions (<italic>p</italic> &lt; 0.001). There were no differences in patient survival for those with DGF and 0, 1 and ≥2 readmissions (<italic>p</italic> = 0.13). Graft survival, however, was lower for those with ≥2 readmissions (<italic>p</italic> &lt; 0.0001). This remained true when accounting for death-censored graft loss (<italic>p</italic> = 0.0012). Additional subgroup analysis was performed on mate kidneys with and without DGF and mate kidneys, both with DGF, with and without readmissions. For these subgroups, there were no differences in patient or graft survival. As a whole, patients with DGF have excellent outcomes, however, patients with DGF requiring ≥2 readmissions have lower graft survival. A better understanding of recipient variables contributing to multiple readmissions may allow for improvements in the utilization of DGF at-risk kidneys.</p>