Emergency Department Visits After Kidney, Liver, and Heart Transplantation in a Hospital of a University Turkey: A Retrospective Study

Abstract

Objectives: In our country, there are few publications evaluating emergency department visits among kidney, liver, and heart transplant recipients. Here, we examined emergency department visits of transplant recipients after initial hospital discharge following organ transplant performed in a medical faculty hospital in Ankara, Turkey.

Materials and Methods: We retrospectively analyzed hospital records of 1144 transplant recipients (700 kidney, 332 liver, and 112 heart) who underwent living-donor and deceased-donor organ transplant procedures in a university hospital between 2007 and 2017 and were admitted to the emergency department during the same period.

Results: The study population (1144 organ transplants) consisted of kidney (61.2%), liver (29.0%), and heart (9.8%) transplant recipients. Among them, 67.9% of kidney transplant recipients and 62.0% of liver transplant recipients were male, whereas 65.2% of heart transplant recipients were female. Average ages were 32.8 +/- 15.5, 24.26 +/- 21.6, and 29.9 +/- 18.7 years, respectively. Among all groups, 41.4% visited the emergency department within 2 years after transplant. Median time to emergency department visit for kidney, liver, and heart transplant recipients was 4.7 months, 3.5 months, and 11.5 months, respectively. Emergency department admissions were due to complaints of abdominal/pelvic pain, fever, nausea/vomiting, hypertension, and nonspecific chest pain. Among all groups, the main diagnoses were most commonly classified by fluid and electrolyte disorders, abnormal results of renal function, urinary tract infections, and acute respiratory infections. One-third of patients were hospitalized.

Conclusions: Nearly one-quarter of kidney transplant recipients, one-fifth of liver transplant recipients, and one-tenth of heart transplant recipients visited the emergency department within 30 days of transplantation. Considering that one-third were rehospitalized, the recipients could be targeted for better transitions of care and for earlier or more frequent outpatient follow-up and also be informed about what symptoms are not normal and in which situations they should seek emergency care.