Beyond the Patient: Exploring the Role of System-Wide Factors and Patient Factors in Driving Readmissions in Kidney Transplant Recipients Within 30 Days After Hospital Discharge: A Retrospective Data Analysis

Background: Renal transplants improve life expectancy and reduce morbidity in end-stage renal disease (ESRD) patients; however, approximately 30% experience readmissions within 30 days of discharge. These readmissions pose significant risks for patient and graft outcomes and increase healthcare costs, influenced by individual patient factors and broader systemic issues. Recognizing these influences is crucial for addressing the challenges of post-transplant care. Methods: This was a single-center, observational retrospective analysis of 30-day readmission at a large, rapidly growing transplant center. The study reviewed patient and system-wide factors that resulted in readmissions of patients who underwent a kidney transplant from 1/1/2024 to 3/31/2025. Results: 130 patients (21% in 2024, 26% in 2025(Jan-March) required readmission within 30 days after their transplant. We did notice an increase in deceased donor readmission from 17% to 22%, and this reflects an increase in a number of transplants and expansion in donor/recipient selection. Data found that DM, HTN, CAD, BPH, Male, Age > 65, DGF, and long index hospitalization played a significant role in readmission. About 26% of the readmissions had a length of stay of < 48hrs and were admitted for medical reasons (GI, anemia, HTN, volume, AKI). 41% in 2024 and 28% in 2025 were avoidable admissions. Conclusion: Based on the analysis of early readmissions in kidney transplant recipients, several opportunities for improvement emerge. One opportunity is to redesign the immediate post-transplant care model in the clinic to accommodate different tracks for high-risk patients, such as diabetic males over 65. Patient education is critical and should begin during the transplant evaluation phase rather than the days immediately following surgery. Furthermore, leveraging data to identify patterns in readmission causes can guide the development of targeted interventions. For example, addressing specific medical issues like hypertension and anemia through post-transplant support programs can significantly mitigate risks. Lastly, exploring systemic changes within the healthcare system, such as streamlined ER processes for transplant patients, may further lower readmission rates and improve overall patient outcomes.