@article{Moghadamyeghaneh_Chen_Alameddine_Jue_Gupta_Burke_Ciancio_2017, title={A nationwide analysis of re-operation after kidney transplant}, volume={11}, url={https://cuaj.ca/index.php/journal/article/view/4369}, DOI={10.5489/cuaj.4369}, abstractNote={<p><strong>Introduction:</strong> We aimed to report the rate and short-term outcomes of patients undergoing re-operation following kidney transplant in the U.S.</p><p><strong>Methods:</strong> The Nationwide Inpatient Sample (NIS) database was used to examine the clinical data of patients undergoing kidney transplant and re-operation during same the hospitalization from 2002‒2012. Multivariate regression analysis was performed to compare outcomes of patients with and without re-operation.</p><p><strong>Results:</strong> We sampled a total of 35 058 patients who underwent kidney transplant. Of these, 770 (2.2%) had re-operation during the same hospitalization. Re-operation was associated with a significant increase in mortality (30.4% vs. 3%; adjusted odds ratio [AOR] 4.62; p<0.01), mean total hospital charges ($249 425 vs. $145 403; p<0.01), and mean hospitalization length of patients (18 vs. 7 days; p<0.01). The most common day of re-operation was postoperative Day 1. Hemorrhagic complication (64.2%) was the most common reason for re-operation, followed by urinary tract complications (9.9%) and vascular complications (3.6%). Preoperative coagulopathy (AOR 3.35; p<0.01) was the strongest predictor of need for re-operation, hemorrhagic complications (AOR 3.08; p<0.01), and vascular complications (AOR 2.50; p<0.01). Also, hypertension (AOR 1.26; p<0.01) and peripheral vascular disorders (AOR 1.25; p=0.03) had associations with hemorrhagic complications.</p><p><strong>Conclusions:</strong> Re-operation after kidney transplant most commonly occurs on postoperative Day 1 and occurs in 2.2% of cases. It is associated with significantly increased mortality, hospitalization length, and total hospital charges. Hemorrhage is the most common complication. Preoperative coagulopathy is the strongest factor predicting the need for re-operation, vascular complications, and hemorrhagic complications.</p>}, number={11}, journal={Canadian Urological Association Journal}, author={Moghadamyeghaneh, Zhobin and Chen, Linda J. and Alameddine, Mahmoud and Jue, Joshua S. and Gupta, Anupam K. and Burke, George and Ciancio, Gaetano}, year={2017}, month={Nov.}, pages={E425–30} }