E. J. Minja1, T. L. Pruett1 1University Of Minnesota,Division Of Solid Organ Transplantation,Minneapolis, MN, USA
Introduction:
Preventing early hospital readmissions is key in reducing medical care cost. Our objective was to determine the incidence and causes of readmissions ≤ 30 days of discharge following an Orthotopic Liver Transplantation (OLT).
Methods:
1028 patients underwent OLTs between 1/1/1997 and 12/31/2014 at our institution . Electronic medical records were reviewed after IRB approval. Causes of readmissions were analyzed. Patients ≤ 18 years were excluded from analysis. Student’s t-test was used to compare groups. A value of p< 0.05 was considered significant.
Results:
Between 1/1/1997 and 12/31/2014, 1028 OLTs were performed, of which 155 (15.1%) were from living donors (LD) and 873 (84.9%) from deceased donors (DD). 931 patients (90.7%) underwent liver alone transplants and 96 patients (9.3%) patients had simultaneous liver and kidney transplants [Table 1].
473 patients (46%) were readmitted ≤ 30 days of discharge. Complete data for analysis was available for 225 patients who received OLTs between 9/2004 and 12/2014. Of this pool of readmitted patients, 188 patients (83.6%) had received DD OLTs vs. 37 patients (16.4%) who had LD OLTs.
The most common cause of hospital readmissions following an OLT was biliary complications. Of the LD OLT recipients readmitted within 30 days of discharge, 43% had biliary complications compared to 13% for DD recipients, p=<0.05. The most common biliary complications amongst LD OLT recipients were bile leaks (50%) and bilomas (31%) [Figure 1-3].
Conclusion:
46% (453/1028) of our patients after OLT were readmitted ≤30 days of discharge representing a significant health care burden. Our data suggests the need to develop predictive models for readmission following OLT and perhaps the need to change our surgical approaches, with goals to reduce preventable hospital readmissions.
