Unplanned readmission within 1 year after heart transplantation in Taiwan.
BACKGROUND
Survival in patients with refractory heart failure greatly improves after heart transplantation (HTx).


OBJECTIVE
To evaluate the rate of unplanned readmission within the first year post-HTx and the causes of such readmission.


METHODS
From January 2005 to June 2008, the 112 patients who underwent HTx were regularly followed up at our hospital. A protocol biopsy was performed every week during the first month, then every 3 months during the first year. Any unplanned readmission was discussed in detail in a transplantation meeting. Data were collected from review of medical records.


RESULTS
The rate of unplanned readmission was 19.3% in 2005, 21.5% in 2006, 22.2% in 2007, and 20.3% in 2008. Infection was the primary cause leading to unplanned readmission in 2005 (51.5%), 2006 (42.9%), and 2008 (30.7%). Rejection was the primary cause leading to readmission in 2007 (40%). Other causes included fluid retention, pericardial effusion, anemia, and systemic diseases.


CONCLUSIONS
To reduce unplanned readmissions and to promote quality of life and long-term survival, health professionals must meticulously monitor the adverse effects of treatments including immunosuppression agents and concomitantly used medications.
Tsao
C-I
CI
Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
Chou
N-K
NK
Chi
N-H
NH
Yu
H-Y
HY
Chen
Y-S
YS
Wang
C-H
CH
Ko
W-J
WJ
Chen
S-C
SC
Wang
S-S
SS
D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D000961:Antilymphocyte Serum / Q000009:adverse effects / Q000627:therapeutic use; D000077552:Basiliximab; D001706:Biopsy; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis; D016027:Heart Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D010347:Patient Care Planning; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010490:Pericardial Effusion / Q000175:diagnosis; D011993:Recombinant Fusion Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use; D013624:Taiwan; D013997:Time Factors
D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D016572:Cyclosporine; D000077552:Basiliximab; D016559:Tacrolimus