Factors Affecting the Hospitalization Period of Kidney Transplantation Recipients

Document Type : Research Paper

Authors

Abstract

Introduction: Nowadays, as many of the problems confronting kidney transplantation have been solved, the number of operations has increased dramatically. So, resource utilization and financial issues have been cited as a new problem for transplantation centres. This study was done to find and assess the factors which can reduce the hospitalization period, while this factor claims the biggest share of the total cost of the treatment process.
Material and Methods: In this retrospective study, done in kidney transplantation word of Imam Reza Hospital, the medical history of 170 kidney transplantation recipients and donors, whose operations were performed between 2000 and 2002, were studied. Collected information of recipient’s characteristics included gender, age, reason for kidney failure, weight, height, blood group, dialysis period, transplantation history, immunosuppressant regimes, complications after operation, and hospitalization after the first discharge due to transplantation operation complications; and for the donors, age, sex and blood group of the donor and the type of donor (cadaver or living) and the relationship between the recipients and the donors were gathered in a questionnaire and analyzed by descriptive statistics and T – test.
Results: A mong all pre-transplant variables only length of dialysis before transplantation and the relationship between donors and recipients were found to be independently significant in predicting the increased hospitalization period and consequently charges.
Conclusion: It is shown that by reducing the waiting time and performing more operations on relative donors and recipients, we can significantly decrease hospitalization period and as a result the cost of treatment.

References

1-Johnson CJ. Pretransplant identification of risk factors that adversely affect length of stays and charges pf renal
transplantation. Clin Transplant 1999; 13: 168-175.
2-Peters TG, Repper SM, Vincent MC .One hundred consecutive living kidney donors: modern issues and
outcomes. Clin Transplant 2002; 16 (7):62-8.
3-Chetwynd J, Swainson C. The cost of renal transplants. N Z Med J 1987 Apr 22; 100(822):247-8.
4-Hilbrands LB, Hoitsma AJ, Koene RA. Costs of drugs used after renal transplantation. Transpl Int 1996; 9 (1)
399-402.
5-Lazzaro C, McKechnie T, McKenna M. Tacrolimus versus cyclosporin in renal transplantation in Italy: costminimisation
and cost-effectiveness analyses. J Nephrol 2002 Sep-Oct; 15(5):580-8.
6-Prabhu R, John GT, Shankar V. Pre-transplant risk factors for renal allograft dysfunction at one year in Indian
patients. Natl Med J India. 2001 Jan-Feb; 14(1):18-21.
7-Matas AJ, Gillingham KJ, Elick BA. Risk factors for prolonged hospitalization after kidney transplants. Clin
Transplant. 1997 Aug; 11(4):259-64.
8-Khan S, Tighiouart H, Kalra A. Resource utilization among kidney transplant recipients. Kidney Int. 2003 Aug;
64(2):657-64.
9-Hagenmeyer EG, Haussler B, Hempel E. Resource use and treatment costs after kidney transplantation: impact of
demographic factors, comorbidities, and complications. Transplantation. 2004 May 27;77(10):1545-50
10- Marks WH, Florence LS, Chapman PH, Precht AF, Perkinson DT. Morbid obesity is not a contraindication to
kidney transplantation. Am J Surg 2004 May; 187(5):635-8.
11- Merion RM, Twork AM, Rosenberg L, Ham JM, Burtch GD, et al. Obesity and renal transplantation. Surg
Gynecol Obstet. 1991 May;172(5):367-76
12- Drafts HH, Anjum MR, Wynn JJ, Mulloy LL, Bowley JN, Humphries AL. The impact of pre-transplant obesity
on renal transplant outcomes. Clin Transplant 1997 Oct; 11(5 Pt 2):493-6.
13- Johnson DW, Isbel NM, Brown AM, Kay TD, Franzen K, Hawley CM, et al.. The effect of obesity on renal
transplant outcomes. Transplantation 2002 Sep 15;74(5):675-81. Comment in: Transplantation. 2002 Sep 15;
74(5):600-1. Transplantation. 2003 Dec 15;76(11):1652; author reply 1651
14- Gore JL, Pham PT, Danovitch GM, Wilkinson AH, Rosenthal JT, Lipshutz GS, SingerJS. Obesity and outcome
following renal transplantation. Am J Transplant 2006 Feb; 6(2):357-63.
15- Meier-Kriesche HU, Arndorfer JA, Kaplan B. The impact of body mass index on renal transplant outcomes: a
significant independent risk factor for graft failure and patient death. Transplantation 2002 Jan 15; 73(1):70-4.
Comment in: Transplantation. 2003 Jan 27; 75(2):249.
16- Hanevold CD, Ho PL, Talley L, Mitsnefes MM. Obesity and renal transplant outcome: a report of the North
American Pediatric Renal Transplant Cooperative Study. Pediatrics. 2005 Feb; 115(2):352-6.
17- Massarweh NN, Clayton JL, Mangum CA, Florman SS, Slakey DP. High body mass index and short- and longterm
renal allograft survival in adults. Transplantation 2005 Nov 27; 80 (10):1430-4.
18- Pesavento TE, Henry ML, Falkenhain ME, Cosio FG, Bumgardner GL, Elkhammas EA, et al .Obese living
kidney donors: short-term results and possible implications Transplantation 1999 Nov 27; 68(10): 1491-6.
19- De Jesus-Gomez G, Santiago-Delpin EA, Gonzalez-Caraballo Z, Morales-Otero L. Study of factors that affect
complications after renal transplantation. Transplant Proc 2006 Apr; 38 (3): 911-3.
20- Johnson DW, Isbel NM, Brown AM. The effect of obesity on renal transplant outcomes. Transplantation 2002
Sep 15; 74(5):675-81.
21- Goldfarb-Rumyantzev A, Hurdle JF, Scandling J, Wang Z, Baird B, Barenbaum L, Cheung AK. Duration of
end-stage renal disease and kidney transplant outcome. Nephrol Dial Transplant. 2005 Jan; 20(1):167-75. Epub
2004 Nov 16.
22- Meier-Kriesche HU, Kaplan B. Waiting time on dialysis as the strongest modifiable risk factor for renal
transplant outcomes: a paired donor kidney analysis. Transplantation 2002 Nov 27; 74(10):1377-81. 
Medical Journal of Mashhad university of Medical Sciences
Volume 50, Issue 1 - Serial Number 1
March and April 2007
Pages 11-16

Files

Share

How to cite

Statistics