Horizons in TransplantationOther clinical transplantationsHospital Readmissions After Intestinal and Multivisceral Transplantation

- This is the first retrospective study to evaluate the causes of readmissions within 1 year.
- Two thirds of intestinal transplant recipients are readmitted within 30 days and almost all within 1 year.
- The primary cause for the readmissions is dehydration due to ileostomy.
- The primary cause for the readmissions after ileostomy take-down is infection.
- Aggressive dehydration prevention and monitoring is a potentially modifiable factor to reduce readmissions.

BackgroundIntestinal transplant recipients require frequent hospital readmission after a successful transplantation, but the reasons for readmission have not been characterized in detail.MethodsWe reviewed our single-center experience to characterize the patterns of readmissions and to identify preventable causes. Among 87 adult patients who received an intestinal or multivisceral transplant, 65 patients (35 males, 30 females; median age, 42 years [range, 19-66]) with a follow-up of at least 1 year were included in this study. Readmissions were defined as any unplanned inpatient hospital stay of 24 hours or longer occurring within 1 year after discharge from the transplantation admission and were classified as early (<1 month) and late (months 2-12) readmissions.ResultsForty-four (68%) patients required early, and 59 (91%) patients required late readmission. A total of 333 readmissions (median, 4 readmissions/patient [0-20]) occurred within the first year post-transplantation; 69 were early (21%) and 264 were late (79%), resulting in a total of 4089 days of hospital stay (median, 7 days/readmission [2-136]). The three most frequent causes of readmission were dehydration, infection, and surgical complications.ConclusionsThese findings suggest that the rate of hospital readmission after intestinal transplantation could potentially be reduced by optimizing fluid balance and hydration status after discharge.