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Kidney Week

Abstract: PO1969

Readmission After Pediatric Kidney Transplantation: A Multicenter Cohort Study

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Benz, Eric, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Godown, Justin, Monroe Carell Junior Children's Hospital at Vanderbilt, Nashville, Tennessee, United States
  • Schaubel, Douglas Earl, University of Pennsylvania Department of Biostatistics and Epidemiology, Philadelphia, Pennsylvania, United States
  • Thurm, Cary W., Children's Hospital Association, Overland Park, Kansas, United States
  • Hall, Matthew, Children's Hospital Association, Overland Park, Kansas, United States
  • Amaral, Sandra, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
Background

The burden of readmission within one year after pediatric kidney transplant (PKTx) is poorly described, with only one single center study describing rates of readmission as high as 79%. We aimed to examine the epidemiology of readmission after PKTx in a national U.S. cohort.

Methods

We linked the Scientific Registry of Transplant Recipients (SRTR) and the Pediatric Health Information System (PHIS) database, a group of over 50 U.S. pediatric medical centers, to identify PKTx recipients <21 years old who received a kidney-only transplant from 2002-2018 and were discharged from the transplant hospitalization with a functioning graft. We characterized the epidemiology of patient demographic, clinical and transplant factors associated with the initial transplant hospitalization and readmission. We also examined risk factors for readmission within a year using multivariable Cox proportional hazard modeling.

Results

We identified 4,566 patients with a median age of 13 years, 46% had CAKUT and 45% were white, non-Hispanic. Within a year, 3,136 (69%) were readmitted. Factors associated with increased hazard of readmission were age <6 years, black race, public insurance, centers with <15 transplants/year and initial transplant admission >10 days. Transplant admission <5 days was associated with decreased hazard of readmission in the first year.

Conclusion

Over two-thirds PKTx recipients were readmitted within a year post-transplant. Readmission was associated with younger age, black race, public insurance, initial transplant hospitalization and transplant center volume. Future studies to identify modifiable risk factors associated with readmission are planned. Our findings can help improve care models to reduce healthcare utilization and cost.

Funding

  • NIDDK Support