Weekend effect on early allograft outcome after kidney transplantation- a multi-centre cohort study

Wai H. Lim, Patrick T. Coates, Graeme R. Russ, Christine Russell, Bulang He, Bryon Jaques, Henry Pleass, Jeremy R. Chapman, Germaine Wong

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)387-398
Number of pages12
JournalTransplant International
Volume32
Issue number4
DOIs
Publication statusPublished - Apr 2019

Cite this

Lim, Wai H. ; Coates, Patrick T. ; Russ, Graeme R. ; Russell, Christine ; He, Bulang ; Jaques, Bryon ; Pleass, Henry ; Chapman, Jeremy R. ; Wong, Germaine. / Weekend effect on early allograft outcome after kidney transplantation- a multi-centre cohort study. In: Transplant International. 2019 ; Vol. 32, No. 4. pp. 387-398.
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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.",
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Lim, WH, Coates, PT, Russ, GR, Russell, C, He, B, Jaques, B, Pleass, H, Chapman, JR & Wong, G 2019, 'Weekend effect on early allograft outcome after kidney transplantation- a multi-centre cohort study' Transplant International, vol. 32, no. 4, pp. 387-398. https://doi.org/10.1111/tri.13377

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 journalArticle

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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

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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

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ER -