Pediatric kidney transplantation: is it safe to perform during night-time or day-off?
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Mar 2024 · 1 min read
In brief
In brief
This retrospective study examines whether performing pediatric kidney transplants during night-time or days-off affects surgical outcomes. While overall complication rates and graft function were similar across timing groups, day-off surgeries showed longer operative times and higher rates of post-operative bleeding, suggesting increased caution may be warranted for weekend procedures.
- 43% of pediatric kidney transplants occurred at night and 29% on days-off, showing after-hours surgery is common in this population.
- Night-time transplants showed similar outcomes to daytime procedures with no difference in complications, graft function, or 3-month eGFR.
- Day-off surgeries had longer operative times and significantly higher rates of post-operative bleeding compared to regular hours.
- Delayed graft function and primary graft non-function rates were comparable across all time periods studied.
- Extra vigilance is warranted for day-off pediatric kidney transplants to prevent severe hemorrhagic complications.
Written by the GCMD Library team from the article.
Abstract
Purpose
To investigate the impact of after-hours surgery on the outcomes of pediatric kidney transplantation (KT).
Methods
Medical records of pediatric KTs performed at a single institution between 2013 and 2021 were retrospectively reviewed. The population was split into three groups according to the incision time and calendar: ordinary day (8.00 AM – 6.30 PM), day-off, and night-time (6.30 PM – 8.00 AM). The following endpoints were compared: ischemia times, length of surgery, complications, delayed graft function (DGF), primary graft non-function (PGNF), and eGFR at three-month follow-up.
Results
Ninety-six non-living donor KTs were performed, median age 11 (IQR 4.3–14) years and median body weight 26 (IQR 13–50) kg. Forty-one (43%) were performed during night-time and 28 (29%) during day-off. Ischemia times were similar (p = 0.769, p = 0.536). Day-off KTs presented an extended length of surgery (p = 0.011). Thirty-two complications were reported in 31 KTs. No difference in the overall rate of complications, DGF, PNGF, and three-month eGFR was found (p = 0.669, p = 0.383, p = 0.949, p = 0.093). Post-operative bleedings were more common in days-off (p = 0.003).
Conclusion
The number of pediatric KTs performed during after-hours was considerable. Even though similar outcomes were reported, more caution should be focused on the KTs performed in days-off to avoid severe complications.