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Kidney Week

Abstract: FR-PO1153

Impact of Delayed Graft Function (DGF) on Length of Stay After a Deceased Donor Kidney Transplant

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • King, Kristen L., Columbia University Medical Center, New York, New York, United States
  • Husain, Syed Ali, Columbia University Medical Center, New York, New York, United States
  • Mayne, Tracy J., Angion BioMedica, San Francisco, California, United States
  • Mohan, Sumit, Columbia University , New York, New York, United States
Background

The goal of the Medicare Diagnosis Related Group bundled payment system was to increase efficiency and decrease cost of hospital care. We examined trends over the past decade on the length of the index hospitalization (LOS) for deceased donor kidney transplant (DDKT) recipients and the impact of the increasing incidence of DGF.

Methods

We identified a cohort of 118,865 patients receiving a DDKT between 1/1/2009 and 12/31/2018, excluding those with LOS >180 days (0.3% of sample). We compared the LOS for patients with and without DGF (defined as the need for dialysis in the first 7 days post-transplant) and estimated the excess LOS attributable to DGF.

Results

From 2009-2018, the incidence of DGF for DDKT rose from 23.9% to 28.3%. Median(IQR) LOS decreased from 8(6-13) to 6(5-10) days for DDKT with DGF but remained significantly higher than LOS for DDKT without DGF, which was unchanged at 5(4-7) days (p<0.001). Despite decreasing LOS for DDKT DGF, patients with DGF accounted for an increasing share of the total LOS for all DDKT, from 32.9% in 2009 to 36.3% in 2018 and the excess LOS attributable to DGF rose by 13% from a total of 10,025 days in 2009 to 11,314 days in 2018. [Fig1]

Conclusion

Although the LOS in DDKT with DGF is decreasing, the increasing incidence of DGF is has led to an absolute increase in the number of hospital days that are attributable to DGF after DDKT.

Fig.1

Funding

  • Commercial Support