Evidence map›Paper›PMID 28834181›Full record

ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2018

Hospital readmissions following HLA-incompatible live donor kidney transplantation: A multi-center study.

Babak J Orandi, Xun Luo, Elizabeth A King, Jacqueline M Garonzik-Wang, Sunjae Bae, Robert A Montgomery, Mark D Stegall, Stanley C Jordan, Jose Oberholzer, Ty B Dunn and 21 more

Abstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Alloimmune Risk Stratification for Kidney Transplant Rejection.Transplant international : official journal of the European Society for Organ Transplantation · 2022
    Article
  4. Delayed graft function and acute rejection following HLA-incompatible living donor kidney transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021
    Article
  5. Article
  6. Review
  7. How do highly sensitized patients get kidney transplants in the United States? Trends over the last decade.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2020
    Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Babak J OrandiDepartment of Surgery, University of California-San Francisco, San Francisco, CA, USA.
Xun LuoDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Elizabeth A KingDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jacqueline M Garonzik-WangDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sunjae BaeDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.ORCID 0000-0003-0098-8816
Robert A MontgomeryThe NYU Transplant Institute, New York University Langone Medical Center, New York , NY, USA.
Mark D StegallDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.
Stanley C JordanDepartment of Medicine, Cedars-Sinai Comprehensive Transplant Center, Los Angeles, CA, USA.
Jose OberholzerDepartment of Surgery, University of Illinois-Chicago, Chicago, IL, USA.
Ty B DunnDepartment of Surgery, University of Minnesota, Minneapolis, MN, USA.ORCID 0000-0002-5941-0659
Lloyd E RatnerDepartment of Surgery, Columbia University Medical Center, New York, NY, USA.
Sandip KapurDepartment of Surgery, New York Presbyterian/Weill Cornell Medical Center, New York, NY, USA.
Ronald P PelletierDepartment of Surgery, The Ohio State University, Columbus, OH, USA.ORCID 0000-0001-6128-8333
John P RobertsDepartment of Surgery, University of California-San Francisco, San Francisco, CA, USA.
Marc L MelcherDepartment of Surgery, Stanford University, Palo Alto, CA, USA.ORCID 0000-0002-7185-4383
Pooja SinghDepartment of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.ORCID 0000-0002-0253-2970
Debra L SudanDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
Marc P PosnerDepartment of Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Jose M El-AmmIntegris Baptist Medical Center, Transplant Division, Oklahoma City, OK, USA.
Ron ShapiroRecanati Miller Transplantation Institute, Mount Sinai Hospital, New York, NY, USA.
Matthew CooperMedstar Georgetown Transplant Institute, Washington, DC, USA.
George S LipkowitzDepartment of Surgery, Baystate Medical Center, Springfield, MA, USA.
Michael A ReesDepartment of Urology, University of Toledo Medical Center, Toledo, OH, USA.
Christopher L MarshDepartment of Surgery, Scripps Clinic and Green Hospital, La Jolla, CA, USA.
Bashir R SankariDepartment of Urology, Cleveland Clinic, Cleveland, OH, USA.
David A GerberDepartment of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Paul W NelsonDepartment of Surgery, University of Nevada, Las Vegas, NV, USA.
Jason WellenDepartment of Surgery, Barnes-Jewish Hospital, St. Louis, MO, USA.
Adel BozorgzadehDepartment of Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA, USA.
A Osama GaberDepartment of Surgery, Houston Methodist Hospital, Houston, TX, USA.
Dorry L SegevDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Funding

Quantifying Risk And Survival Benefit from Incompatible Kidney TransplantationR01DK098431 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SEGEV, DORRY L. · 2013 to 2017
$3.7M
Patient Oriented Research in Kidney Disease and Transplant SurgeryK24DK101828 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SEGEV, DORRY L. · 2014 to 2018
$922k
Quantifying Risk and Survival Benefit from Incompatible Kidney TransplantationF32DK093218 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI ORANDI, BABAK JOHN · 2011 to 2014
$185k
NIDDK NIH HHS F32 DK093218NIDDK NIH HHS K24 DK101828NIDDK NIH HHS R01 DK098431
6 · The paper itself

Abstract

Thirty percent of kidney transplant recipients are readmitted in the first month posttransplantation. Those with donor-specific antibody requiring desensitization and incompatible live donor kidney transplantation (ILDKT) constitute a unique subpopulation that might be at higher readmission risk. Drawing on a 22-center cohort, 379 ILDKTs with Medicare primary insurance were matched to compatible transplant-matched controls and to waitlist-only matched controls on panel reactive antibody, age, blood group, renal replacement time, prior kidney transplantation, race, gender, diabetes, and transplant date/waitlisting date. Readmission risk was determined using multilevel, mixed-effects Poisson regression. In the first month, ILDKTs had a 1.28-fold higher readmission risk than compatible controls (95% confidence interval [CI] 1.13-1.46; P < .001). Risk peaked at 6-12 months (relative risk [RR] 1.67, 95% CI 1.49-1.87; P < .001), attenuating by 24-36 months (RR 1.24, 95% CI 1.10-1.40; P < .001). ILDKTs had a 5.86-fold higher readmission risk (95% CI 4.96-6.92; P < .001) in the first month compared to waitlist-only controls. At 12-24 (RR 0.85, 95% CI 0.77-0.95; P = .002) and 24-36 months (RR 0.74, 95% CI 0.66-0.84; P < .001), ILDKTs had a lower risk than waitlist-only controls. These findings of ILDKTs having a higher readmission risk than compatible controls, but a lower readmission risk after the first year than waitlist-only controls should be considered in regulatory/payment schemas and planning clinical care.

Indexed as

Postoperative ComplicationsAdultBlood Group IncompatibilityCase-Control StudiesFemaleFollow-Up StudiesGlomerular Filtration RateGraft SurvivalHLA AntigensHospitalizationHumansIsoantibodiesKidney Failure, ChronicKidney Function TestsKidney TransplantationLiving DonorsHLA AntigensIsoantibodiesclinical research/practicedesensitizationeconomicshealth services and outcomes researchhospital readmissionkidney transplantation: living donorkidney transplantation/nephrologyorgan transplantation in generalquality of care/care delivery

Identifiers

PMID28834181
PMCPMC5820188

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.