Towards Improving the Transfer of Care of Kidney Transplant Recipients

Abstract

Kidney transplant recipients require specialized medical care and may be at risk for adverse health outcomes when their care is transferred. This document provides opinion‐based recommendations to facilitate safe and efficient transfers of care for kidney transplant recipients including minimizing the risk of rejection, avoidance of medication errors, ensuring patient access to immunosuppressant medications, avoidance of lapses in health insurance coverage, and communication of risks of donor disease transmission. The document summarizes information to be included in a medical transfer document and includes suggestions to help the patient establish an optimal therapeutic relationship with their new transplant care team. The document is intended as a starting point towards standardization of transfers of care involving kidney transplant recipients.

Outcomes Following Colorectal Resection in Kidney Transplant Recipients

“…Despite the sentiments expressed in multiple opinion pieces including book chapters and editorials, we did not find better outcomes for transplant recipients at transplant centers. [13,14,27] In fact, we found that KTR had a 15% longer LOS when treated at transplant centers. Given the constellation of similar mortality, morbidity and cost in the setting of longer LOS at transplant centers, the longer LOS does not appear to be attributable to a difference in illness severity at transplant centers compared to non-transplant centers.…”

Beyond Survival in Solid Organ Transplantation: A Summary of Expert Presentations from the Sandoz 6th Standalone Transplantation Meeting, 2018

“…Due to the increase in the prevalence of patients with a functioning graft requiring long-term follow-up, 78 transfers of posttransplant care from the transplant center to another institution are increasingly required. 79 Transfers may occur early (<6 mo) or later (>6 mo) after transplant and should be considered when the patient has established clinical stability (Table 1).…”

Complications, length of stay, and cost of cholecystectomy in kidney transplant recipients

“…Despite the sentiments expressed in multiple opinion pieces including book chapters and editorials, we did not find better outcomes for transplant recipients at transplant centers. 10,12,28 While there was a significantly higher percentage of cholecystectomies performed at transplant centers in the KTR population (54.6%) compared to the non-KTR group (16.8%), the mortality, morbidity, LOS and cost were similar for KTR regardless of center type. In our examination of these outcomes, we adjusted for surgical approach, controlling the impact that laparoscopic vs. open case differences had on the association of KTR status and our outcomes of interest.…”