Z KUAH 1, S JAHAN 1, S BHATTACHARJYA 1, P COATES 1
1CNARTS, Adelaide, Australia
Aim: Kidney transplantation is the treatment of choice for patients with end stage kidney disease. ICU admissions post transplants are quoted variably in literature between 3-42% and little is known about the pre-operative risk factors or pre-morbid conditions leading to ICU admissions.
Background: Central Northern Adelaide Renal and Transplantation Service (CNARTS) transplant between 70-100 patients per year and the rates of ICU admission immediately post-transplant is relatively low. Our aim is to discharge patients home day 3 post-transplant and therefore ICU admissions are a significant cause for delay of that discharge date. ICU admissions are historically for provision of specialised care that is not able to be provided on the general ward.
Methods: Single centre 3.5-year retrospective analysis of all patients receiving kidney transplantation from Sept 2017 to Mar 2021 and review of cause of admission to ICU, demographics and comorbidity identification
Results: There were 280 kidney only transplants in the 3.5 year period. 38/280 (14%) had ICU admissions post operatively. 22/38 (58%) were male. Age range was between 23-70 years. 6/38 (16%) were Aboriginal background. Hypotension was the leading cause of admission as found in 31/38 (82%) patients. Allergic reaction to intra-operative medications caused ICU admission in 2 patients. Only 1 admission was due to post-operative bleed. 17/38 (45%) had diabetes, 6/38 had prior CABG and 11/38 (29%) were ex/current smokers and 4/38 had obstructive sleep apnoea.
Conclusions: Rates of ICU admission are low in our unit post kidney transplantation with the largest cause being hypotension. Multi-morbid background is a presumed cause of hypotension with diabetes being a significant factor.
Sadia is a nephrology trainee from the Royal Adelaide Hospital with an evolving enthusiasm for all things transplant.