Abstract
Weekend surgery may be associated with a higher risk of early complications, but the effect of the timing of kidney transplant surgery on early allograft outcome remains uncertain. The aim of this study is to evaluate whether the association between weekend transplant surgery and allograft failure was modified by prevalent vascular disease. Using data from the Australia and New Zealand Dialysis and Transplant registry, we examined the association between weekend status and 90-day and 1-year allograft failure in deceased donor transplant recipients between 1994-2012. Two-way interaction between vascular disease and weekend status was examined. Of 6622 recipients, 1868 (28.2%) received transplants during weekends. Compared with weekday transplants, weekend transplants were associated with an adjusted hazard ratio (HR) for 90-day and 1-year allograft failure of 0.99 (0.78-1.25; P = 0.917) and 0.93 (0.76-1.13, P = 0.468), respectively. There was a significant interaction between prevalent vascular disease and weekend status for 90-day allograft failure (P-interaction = 0.008) but not at 1-year, such that patients with vascular disease were more likely to experience 90-day allograft failure if transplanted on weekend (versus weekdays), particularly failures secondary to vascular complications. Timing of transplantation does not impact on allograft outcome, although those with vascular disease may benefit from more intensive post-transplant follow-up for potential vascular complications.
Original language | English |
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Pages (from-to) | 387-398 |
Number of pages | 12 |
Journal | Transplant International |
Volume | 32 |
Issue number | 4 |
DOIs | |
Publication status | Published - Apr 2019 |
Cite this
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Weekend effect on early allograft outcome after kidney transplantation- a multi-centre cohort study. / Lim, Wai H.; Coates, Patrick T.; Russ, Graeme R.; Russell, Christine; He, Bulang; Jaques, Bryon; Pleass, Henry; Chapman, Jeremy R.; Wong, Germaine.
In: Transplant International, Vol. 32, No. 4, 04.2019, p. 387-398.Research output: Contribution to journal › Article
TY - JOUR
T1 - Weekend effect on early allograft outcome after kidney transplantation- a multi-centre cohort study
AU - Lim, Wai H.
AU - Coates, Patrick T.
AU - Russ, Graeme R.
AU - Russell, Christine
AU - He, Bulang
AU - Jaques, Bryon
AU - Pleass, Henry
AU - Chapman, Jeremy R.
AU - Wong, Germaine
PY - 2019/4
Y1 - 2019/4
N2 - Weekend surgery may be associated with a higher risk of early complications, but the effect of the timing of kidney transplant surgery on early allograft outcome remains uncertain. The aim of this study is to evaluate whether the association between weekend transplant surgery and allograft failure was modified by prevalent vascular disease. Using data from the Australia and New Zealand Dialysis and Transplant registry, we examined the association between weekend status and 90-day and 1-year allograft failure in deceased donor transplant recipients between 1994-2012. Two-way interaction between vascular disease and weekend status was examined. Of 6622 recipients, 1868 (28.2%) received transplants during weekends. Compared with weekday transplants, weekend transplants were associated with an adjusted hazard ratio (HR) for 90-day and 1-year allograft failure of 0.99 (0.78-1.25; P = 0.917) and 0.93 (0.76-1.13, P = 0.468), respectively. There was a significant interaction between prevalent vascular disease and weekend status for 90-day allograft failure (P-interaction = 0.008) but not at 1-year, such that patients with vascular disease were more likely to experience 90-day allograft failure if transplanted on weekend (versus weekdays), particularly failures secondary to vascular complications. Timing of transplantation does not impact on allograft outcome, although those with vascular disease may benefit from more intensive post-transplant follow-up for potential vascular complications.
AB - Weekend surgery may be associated with a higher risk of early complications, but the effect of the timing of kidney transplant surgery on early allograft outcome remains uncertain. The aim of this study is to evaluate whether the association between weekend transplant surgery and allograft failure was modified by prevalent vascular disease. Using data from the Australia and New Zealand Dialysis and Transplant registry, we examined the association between weekend status and 90-day and 1-year allograft failure in deceased donor transplant recipients between 1994-2012. Two-way interaction between vascular disease and weekend status was examined. Of 6622 recipients, 1868 (28.2%) received transplants during weekends. Compared with weekday transplants, weekend transplants were associated with an adjusted hazard ratio (HR) for 90-day and 1-year allograft failure of 0.99 (0.78-1.25; P = 0.917) and 0.93 (0.76-1.13, P = 0.468), respectively. There was a significant interaction between prevalent vascular disease and weekend status for 90-day allograft failure (P-interaction = 0.008) but not at 1-year, such that patients with vascular disease were more likely to experience 90-day allograft failure if transplanted on weekend (versus weekdays), particularly failures secondary to vascular complications. Timing of transplantation does not impact on allograft outcome, although those with vascular disease may benefit from more intensive post-transplant follow-up for potential vascular complications.
KW - allograft loss
KW - kidney transplantation
KW - registry
KW - vascular disease
KW - weekend
KW - MORTALITY
KW - ADMISSION
KW - GRAFT
KW - TIME
U2 - 10.1111/tri.13377
DO - 10.1111/tri.13377
M3 - Article
VL - 32
SP - 387
EP - 398
JO - Transplant International
JF - Transplant International
SN - 0934-0874
IS - 4
ER -