Effects of adverse drug events on readmission of renal transplant recipients and survival of kidney transplants
10.3760/cma.j.cn114015-20210601-00624
- VernacularTitle:药物不良事件对肾移植受者再入院及移植肾存活的影响
- Author:
Zhongling HAN
1
;
Jianhua WU
;
Yufeng XUE
;
Li YANG
;
Haiyan ZHENG
;
Jing YANG
;
Liang TENG
Author Information
1. 新疆军区总医院北京路医疗区药剂科，乌鲁木齐 830013
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Immunosuppressive agents;
Graft rejection;
Risk factors;
Drug-related side effects and adverse reactions;
Global trigger tool
- From:
Adverse Drug Reactions Journal
2022;24(1):24-29
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the impact of adverse drug events (ADE) on readmission in renal transplant recipients and survival of the transplanted kidney.Methods:The hospital information system was searched and medical records of patients who underwent renal transplantation in Beijing Road Medical Area of Xinjiang Military Region General Hospital from January 2008 to December 2018 and were re-admitted at least once (as of December 2020) were collected and analyzed retrospectively. Patient information such as gender, age, weight, ethnicity, kidney transplantation status, postoperative immunosuppressive treatment plan, readmission status, and kidney transplant survival time was extracted and the ADE signals were detected through reviewing the patient re-admission medical history using a self-established global trigger tool. The correlation between ADE and readmission was evaluated by Karch and Lasagna method; patients were included in the ADE-related readmission group (ADE admission group) and the non-ADE-related readmission group (non-ADE admission group) based on the correlation results. The clinical characteristics and the cumulative survival rate of kidney transplants between the 2 groups were compared.Results:A total of 198 patients (1 426 times of readmission) were entered in the analysis, including 154 males and 44 females with an age of 14-62 years, and 118(59.6%) were Han nationality. The immunosuppressive drugs included cyclosporine, tacrolimus, sirolimus, etc. After renal transplantation, 240 times of readmission (16.8%) in 94 patients (47.5%) were associated with ADE. In the ADE readmission group, the number of diagnosed diseases and postoperative readmission times were more and the length of hospital stay was longer than those in the non-ADE readmission group [4 (3,6) vs. 3 (2,5), P=0.001; 6(3, 9) times vs. 4 (2, 8) times, P=0.022; 20(13, 33) days vs. 14 (11, 25) days, P=0.010]. Kaplan-Meier curve showed that the 1-, 3-, 5-, and 10-year cumulative survival rates of kidney transplants were 90.1%, 84.1%, 79.0%, and 57.6% in ADE-related readmission group, which were 99.0%, 94.7%, 90.8%, and 80.4% in non-ADE-related readmission, and the difference was statistically significant ( P=0.001). Conclusions:ADE can increase the readmission times, prolong the length of hospital stay, and reduce the cumulative survival rate of kidney transplants. The monitoring of ADE in renal transplant recipients should be strengthened.
