| Popis: |
Introduction: Kidney transplantation offers superior quality of life and survival compared to dialysis although involves invasive procedures, hospitalisation, clinic attendances, and risk of intercurrent illness. In this study we demonstrate visually and numerically the breadth and depth of activity incurred by transplantation when considering the patient journey. Methods: Consecutive patients in the Glasgow Renal and Transplant Unit (UK) in receipt of a kidney transplant during 2015 were studied. Demographics and events of interest were collated from electronic patient records for 2 years following transplantation. Results: 132 patients were transplanted. The median number of clinical contact days over 2 years was 47; 12 in-patient days, 3 day ward attendances, and 28 out-patient appointments. 46% of clinical contact days occurred in the first 90 days. In-patient days, were higher in both BMI >30kg/m2 and in extended criteria donor subgroups. 64/132 (48.5%) experienced at least one clinically significant infection requiring antibiotics, antivirals, and/or a reduction in immune-suppression; 9/132 (6.8%) experienced 10 or more infections. An average of 8.2 imaging studies were undertaken per patient; half of these within the first 90 days (540/1090, 49.5%). Transplant biopsy was performed on 86 occasions in 50/132 (37.9%); 45/86 biopsies (52.3%) occurred in the first 90 days. 16/132 (12.1%) experienced an episode of biopsy-proven acute rejection. Over 2 years, 11/132 lost graft function (8.3%), and 8/132 recipients died (6.1%). Discussion: The effect of aggregating these data is to provide a granular map of the post-transplant period. This offers greater insights into what patients may expect following receipt of their kidney transplant, the resources required to support care longitudinally, and seeks to assist in the evolution of care models and definitions of quality. |
