Abstract:
:A lack of research exploring post-transplant process optimization to reduce readmissions and increasing readmission rates at our center from 2009 to 2013 led to this study, aimed at assessing the effect of patient and process factors on 30-d readmission rates after kidney transplantation. This was a retrospective case-control study in adult kidney transplant recipients. Univariate and multivariate analyses were utilized to assess patient and process determinants of 30-d readmissions. 384 patients were included; 30-d readmissions were significantly associated with graft loss and death (p = 0.001). Diabetes (p = 0.049), pharmacist identification of poor understanding or adherence, and prolonged time on hemodialysis prior to transplant were associated with an increased risk of 30-d readmissions. After controlling for risk factors, readmission rates were only independently predicted by pharmacist identification of patient lack of understanding or adherence regarding post-transplant medications and dialysis exposure for more than three yr (OR 2.3, 95% CI 1.10-4.71, p = 0.026 and OR 2.1, 95% CI 1.22, 3.70, respectively), both of which were significantly modified by history of diabetes. Thirty-d readmissions are attributable to both patient and process-level factors. These data suggest that a lack of post-transplant medication knowledge in high-risk patients drives early hospital readmission.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Covert KL,Fleming JN,Staino C,Casale JP,Boyle KM,Pilch NA,Meadows HB,Mardis CR,McGillicuddy JW,Nadig S,Bratton CF,Chavin KD,Baliga PK,Taber DJdoi
10.1111/ctr.12748subject
Has Abstractpub_date
2016-07-01 00:00:00pages
779-86issue
7eissn
0902-0063issn
1399-0012journal_volume
30pub_type
杂志文章abstract::A 29-year-old man wanted to receive an ABO-incompatible kidney transplant. His blood type was O, and the donor, his father, was A1. After endoscopic splenectomy performed before kidney transplantation, the recipient developed a high fever and leukocytosis, and he was treated with antibiotics and 5 g of human immunoglo...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1046/j.1399-0012.2003.00144.x
更新日期:2004-04-01 00:00:00
abstract::Hepatitis C virus (HCV) infection is highly prevalent in renal transplant candidates; however, its effect on the transplant outcome is still controversial. The aim of the present study was to determine the effect of HCV infection in the outcome of kidney transplantation in a single transplant center. The study populat...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00679.x
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The burden of mast cell (MC) infiltration and their phenotypes, MC-tryptase (MCT ) and MC-tryptase/chymase (MCTC ), after lung transplantation (LT) has not been evaluated in human studies. METHODS:We reviewed 20 transbronchial lung biopsy (TBLB) specimen from patients with early normal allograft (<6 months ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12758
更新日期:2016-07-01 00:00:00
abstract:INTRODUCTION:Recurrence of hepatitis C virus (HCV) in hepatic allograft is a major concern after successful liver transplant (LTx). AIM:To examine the response rate to pegylated interferon (PEG-IFN) and ribavirin in post-LTx patients with HCV recurrence. PATIENTS AND METHODS:Between January 2003 and September 2006, 6...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.00961.x
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The clinical consequences of type 1 diabetes mellitus (IDDM) include diabetic triopathy: retinopathy, nephropathy, and neuropathy, as well as microangiopathy, accelerated atherosclerotic disease, and hypercoagulability. The etiology of the hypercoagulability is multifactorial, involving various clotting fact...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00183.x
更新日期:2004-08-01 00:00:00
abstract::In view of the scarcity of organ resources available for transplantation, living donor liver transplantation (LDLT) is gaining growing importance in the treatment of chronically terminal liver diseases. In the period between December 1999 and October 2000, 47 potential living liver donors were evaluated and 24 right h...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2002.02002.x
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:As Gastroesophageal reflux disease (GORD) affects long-term survival in lung transplant recipients, the aim of this observational prospective study was to analyze the efficacy of The Reflux Symptom Index Questionnaire (RSI) compared to the esophageal impedance test. METHODS:Both esophageal impedance studies ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12656
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Chronic allograft nephropathy (CAN), associated with late-allograft dysfunction is caused by alloantigen-dependent and -independent mechanisms, and eventually leads to interstitial fibrosis (ci). Activation of complement cascade is considered to be a poor prognostic marker of graft survival. This study was d...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00426.x
更新日期:2005-12-01 00:00:00
abstract::Of 1463 liver allograft recipients receiving the combination of FK506 and steroids as their primary immunosuppressive regimen, 2 patients developed Kaposi's sarcoma. Although previously described as a complication of organ transplantation, this is the first case report of Kaposi's sarcoma occurring in association with...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Although risk factors for failure of renal retransplants have been well studied, the impact of allograft nephrectomy on subsequent renal transplantation in the cyclosporin era is not well defined. The purpose of this study is to define the effect of nephrectomy of the primary allograft on subsequent allograft survival...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Stem cell-based therapy has received attention as a possible alternative to organ transplantation. The aim of this study was to assess the safety and efficacy of autologous transplantation of bone marrow (BM)-derived stromal cells in post-HCV liver cirrhosis patients. METHODOLOGY:10 × 10(6) of isolated huma...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12179
更新日期:2013-07-01 00:00:00
abstract::Based on the results achieved in single human hand transplantations, we decided to perform the first double hand transplantation with a conventional immunosuppressive protocol in a patient with a high potential for functional recovery. Two years after transplantation the efficacy and the safety of this immunosuppressi...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2003.00005.x
更新日期:2003-10-01 00:00:00
abstract::The stress, coping resources, and family functioning of 36 mothers of children awaiting transplantation were evaluated. Using standardized assessment techniques, we found that, overall, 20% of mothers reported clinically elevated stress responses and that parenting stress was higher for mothers of children evaluated f...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
abstract::Angiotensin-converting enzyme inhibitor (ACEI) has become recognized as agents that have renoprotective effects in the treatment of progressive renal diseases including post-transplant kidneys. Previously we demonstrated the safety and effectiveness of ACEI treatment on the hypertensive proteinuric post-transplant pat...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00244.x
更新日期:2004-01-01 00:00:00
abstract::The current pandemic SARS-CoV-2 has required an unusual allocation of resources that can negatively impact chronically ill patients and high-complexity procedures. Across the European Reference Network on Pediatric Transplantation (ERN TransplantChild), we conducted a survey to investigate the impact of the COVID-19 o...
journal_title:Clinical transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/ctr.14063
更新日期:2020-10-01 00:00:00
abstract::Diabetic transplant recipients are at a high risk for foot pathology leading to amputation. This retrospective study from 1/85 to 2/95 examines the risk of foot complications in a population (n = 340) of diabetic renal and combined renal/pancreas transplant recipients. All groups suffered high lower extremity amputati...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract::Pancreas transplant longevity is limited by immune rejection, which is diagnosed by graft biopsy using the Banff Classification. The histological criteria for antibody-mediated rejection (AMR) are poorly reproducible and inconsistently associated with outcome. We hypothesized that a 34-gene set associated with antibod...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14065
更新日期:2020-11-01 00:00:00
abstract::Adverse symptoms of immunosuppressants (ASI) impact quality of life (QOL) in solid organ transplant recipients; however, standardized approaches for active ASI surveillance and intervention are lacking. While management is highly clinician dependent, clinician views remain largely unexplored. We surveyed Canadian Soci...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12940
更新日期:2017-05-01 00:00:00
abstract::Coronary angiography (CA) is the gold standard evaluation of coronary artery disease in potential multi-organ donors. This use of iodinated contrast media could lead to contrast-induced acute kidney injury and consequently to delayed graft function (DGF). All patients in France who received a kidney from a 45-70-year-...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13355
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Our purpose was to determine the complication rate from intravascular ultrasound (IVUS) in a large, multicenter cohort of pediatric heart transplant (PHT) patients. METHODS:We retrospectively reviewed all PHT who underwent IVUS at 5 institutions (2006-2014). Rates of major and minor complications were calcu...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13981
更新日期:2020-09-01 00:00:00
abstract::Anti-Xa monitoring for low molecular weight heparin (LMWH) is currently recommended in obese, renally impaired, and pregnant patients. Substantial evidence indicates that solid organ transplant (SOT) patients are at an increased risk of renal impairment, thus representing a population at risk of LMWH accumulation. The...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12240
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:A questionnaire study was designed to determine whether the quality of life benefit provided by receiving a kidney-pancreas (KP) transplant increased the incentive to return to work, compared with patients receiving a kidney alone (KA) transplant. METHODS:A confidential questionnaire was sent to 58 patients...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00115.x
更新日期:2004-02-01 00:00:00
abstract::Renal transplantation was performed in a 24-yr-old woman with type AA systemic amyloidosis. Renal biopsy at 11 yr post-transplantation showed no amyloid recurrence, but the presence of mesangial proliferative glomerulonephritis and focal segmental glomerular sclerosis. Renal function was satisfactory with the exceptio...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Simultaneous pancreas and kidney (SPK) and pancreas after kidney (PAK) transplant are both potential options for diabetic ESRD patients. Historically, PAK pancreas graft outcomes were felt to be inferior to SPK pancreas graft outcomes. Little is known about outcomes in the modern era of transplantation. We analyzed ou...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13732
更新日期:2019-12-01 00:00:00
abstract::These updated guidelines from the American Society of Transplantation Infectious Diseases Community of Practice provide recommendations for the diagnosis and management of Candida infections in solid organ transplant recipients. Candida infections manifest primarily as candidemia and invasive candidiasis and cause con...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13623
更新日期:2019-09-01 00:00:00
abstract::In the general population, obesity is associated with an increased risk of developing hypertension (HTN), type 2 diabetes mellitus (DM), and end-stage renal disease (ESRD). Therefore, most transplant centers have a body mass index (BMI) threshold for accepting living kidney donors. But there have been no studies of po...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13360
更新日期:2018-09-01 00:00:00
abstract::It is unclear whether a concomitant kidney transplant grants survival benefit to liver transplant (LT) candidates with renal dysfunction (RD). We retrospectively studied LT candidates without RD (n = 714) and LT candidates with RD who underwent either liver transplant alone (RD-LTA; n = 103) or simultaneous liver-kidn...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12479
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The role of advanced age live donors remains controversial because of decline in glomerular filtration rate and perceived increased risks of perioperative complications. METHODS:A retrospective review of all live donor transplants performed from January 2000 to December 2003. RESULTS:Seventy-eight live don...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00328.x
更新日期:2005-10-01 00:00:00
abstract::The aim of this study was to identify indicators of outcome prior to transplantation in allogeneic hematopoietic stem cell transplantation (HCT). Clinical data of 106 patients with acute leukemia were retrospectively analyzed. We examined the role of pre-conditioning serum C-reactive protein (CRP) and ferritin levels,...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12028
更新日期:2012-09-01 00:00:00
abstract::We performed a systematic search of the literature using the MEDLINE (through 2006) database to identify the patient-reported outcome measures of quality of life (QOL) used most often in the renal transplant literature. After applying limits and reviewing references, we identified 338 renal transplant articles with a ...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2007.00784.x
更新日期:2008-05-01 00:00:00