TY - JOUR
T1 - Burden of early hospitalization after simultaneous liver–kidney transplantation
T2 - Results from the US Multicenter SLKT Consortium
AU - Sharma, Pratima
AU - Xie, Jiaheng
AU - Wang, Leyi
AU - Zhang, Min
AU - Magee, John
AU - Answine, Adeline
AU - Barman, Pranab
AU - Jo, Jennifer
AU - Sinha, Jasmine
AU - Schluger, Aaron
AU - Perreault, Gabriel J.
AU - Walters, Kara E.
AU - Cullaro, Giuseppe
AU - Wong, Randi
AU - Filipek, Natalia
AU - Biggins, Scott W.
AU - Lai, Jennifer C.
AU - VanWagner, Lisa B.
AU - Verna, Elizabeth C.
AU - Patel, Yuval A.
N1 - Funding Information:
This work was supported by AST‐LICOP educational committee and an intramural MCUBE 3.0 grant from Michigan Medicine. Lisa VanWagner is supported by National Heart, Lung and Blood Institute Grant K23 HL136891.
Funding Information:
This work was supported by American Society of Transplantation‐Liver and Intestine Community of Practice educational committee and an intramural MCUBE 3.0 grant from Michigan Medicine. Lisa B. VanWagner is supported by National Heart, Lung and Blood Institute Grant K23 HL136891
Publisher Copyright:
© 2022 American Association for the Study of Liver Diseases.
PY - 2022/11
Y1 - 2022/11
N2 - The burden of early hospitalization (within 6 months) following simultaneous liver–kidney transplant (SLKT) is not known. We examined risk factors associated with early hospitalization after SLKT and their impact on patient mortality conditional on 6-month survival. We used data from the US Multicenter SLKT Consortium cohort study of all adult SLKT recipients between 2002 and 2017 who were discharged alive following SLKT. We used Poisson regression to model rates of early hospitalizations after SLKT. Cox regression was used to identify risk factors associated with mortality conditional on survival at 6 months after SLKT. Median age (N = 549) was 57.7 years (interquartile range [IQR], 50.6–63.9) with 63% males and 76% Whites; 33% had hepatitis C virus, 20% had non–alcohol-associated fatty liver disease, 23% alcohol-associated liver disease, and 24% other etiologies. Median body mass index (BMI) and Model for End-Stage Liver Disease–sodium scores were 27.2 kg/m2 (IQR, 23.6–32.2 kg/m2) and 28 (IQR, 23–34), respectively. Two-thirds of the cohort had at least one hospitalization within the first 6 months of SLKT. Age, race, hospitalization at SLKT, diabetes mellitus, BMI, and discharge to subacute rehabilitation (SAR) facility after SLKT were independently associated with a high incidence rate ratio of early hospitalization. Number of hospitalizations within the first 6 months did not affect conditional survival. Early hospitalizations after SLKT were very common but did not affect conditional survival. Although most of the risk factors for early hospitalization were nonmodifiable, discharge to SAR after initial SLKT was associated with a significantly higher incidence rate of early hospitalization. Efforts and resources should be focused on identifying SLKT recipients at high risk for early hospitalization to optimize their predischarge care, discharge planning, and long-term follow-up.
AB - The burden of early hospitalization (within 6 months) following simultaneous liver–kidney transplant (SLKT) is not known. We examined risk factors associated with early hospitalization after SLKT and their impact on patient mortality conditional on 6-month survival. We used data from the US Multicenter SLKT Consortium cohort study of all adult SLKT recipients between 2002 and 2017 who were discharged alive following SLKT. We used Poisson regression to model rates of early hospitalizations after SLKT. Cox regression was used to identify risk factors associated with mortality conditional on survival at 6 months after SLKT. Median age (N = 549) was 57.7 years (interquartile range [IQR], 50.6–63.9) with 63% males and 76% Whites; 33% had hepatitis C virus, 20% had non–alcohol-associated fatty liver disease, 23% alcohol-associated liver disease, and 24% other etiologies. Median body mass index (BMI) and Model for End-Stage Liver Disease–sodium scores were 27.2 kg/m2 (IQR, 23.6–32.2 kg/m2) and 28 (IQR, 23–34), respectively. Two-thirds of the cohort had at least one hospitalization within the first 6 months of SLKT. Age, race, hospitalization at SLKT, diabetes mellitus, BMI, and discharge to subacute rehabilitation (SAR) facility after SLKT were independently associated with a high incidence rate ratio of early hospitalization. Number of hospitalizations within the first 6 months did not affect conditional survival. Early hospitalizations after SLKT were very common but did not affect conditional survival. Although most of the risk factors for early hospitalization were nonmodifiable, discharge to SAR after initial SLKT was associated with a significantly higher incidence rate of early hospitalization. Efforts and resources should be focused on identifying SLKT recipients at high risk for early hospitalization to optimize their predischarge care, discharge planning, and long-term follow-up.
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U2 - 10.1002/lt.26523
DO - 10.1002/lt.26523
M3 - Article
C2 - 35665591
AN - SCOPUS:85133306763
SN - 1527-6465
VL - 28
SP - 1756
EP - 1765
JO - Liver Transplantation
JF - Liver Transplantation
IS - 11
ER -
