Clinical correlates, outcomes and healthcare costs associated with early mechanical ventilation after kidney transplantation

Hui Yuan, Janet E. Tuttle-Newhall, Mark Dy-Liacco, Mark A. Schnitzler, Nino Dzebisashvili, Huiling Xiao, David Axelrod, Brian Holt, Krista L. Lentine

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Background Information is lacking on the frequency, clinical implications, and costs of respiratory failure requiring mechanical ventilation after kidney transplantation. Methods US Renal Data System records for Medicare-insured kidney transplant recipients (1995 to 2007; n = 88,392) were examined to identify post-transplantation mechanical ventilation from billing claims within 30 days after transplantation. Results Post-transplantation mechanical ventilation was required among 2.1% of the cohort. Independent correlates of early mechanical ventilation included recipient age, low body mass index, coronary artery disease, and cerebrovascular disease. Post-transplantation mechanical ventilation was twice as likely with delayed graft function (adjusted odds ratio, 2.13; P <.001) and 35% lower among recipients of living versus deceased donor allografts. Patients needing early mechanical ventilation experienced 5-fold higher 1-year mortality, as well as significantly higher Medicare costs during the transplant hospitalization and first post-transplantation year. Conclusions Recognition of patients at risk for post-transplantation respiratory failure may help direct protocols for reducing the incidence and consequences of this complication.

Original languageEnglish (US)
Pages (from-to)686-692
Number of pages7
JournalAmerican Journal of Surgery
Issue number5
StatePublished - Nov 2013


  • Graft failure
  • Health care costs
  • Kidney transplantation
  • Mechanical ventilation
  • Medicare

ASJC Scopus subject areas

  • Surgery


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