title: Outcomes After Weekend Admission for Deceased Donor Kidney Transplantation: A Population Cohort Study.
abstract: Outcomes for weekend hospital admissions or emergency procedures have become a topical and controversial issue for the UK National Health Service. Deceased-donor kidney transplantation is frequently performed at weekends and evidence for its relative safety are lacking.
  
  
  
  We undertook a population-based cohort analysis, obtaining data from every deceased-donor kidney-alone transplant procedure performed in England between January 2003 and December 2014. Data were extracted from Hospital Episode Statistics, with linkage to the Office for National Statistics to create a comprehensive dataset for mortality, rehospitalization and kidney allograft failure/rejection for weekend (defined as Friday to Sunday) versus weekday transplantation.
  
  
  
  Data were extracted for 12 902 deceased-donor kidney alone transplants performed in all 19 English transplant centres between 2003 and 2014. Based on initial χ tests, no significant difference was observed when comparing weekend versus weekday transplantation in 30-day (0.9% vs 1.2%; P = 0.126) or 1-year mortality (3.7% vs 3.8%; P = 0.788), 1-year kidney allograft failure/rejection (16.7% vs 16.8%; P = 0.897), delayed graft function (29.97% vs 29.36%; P = 0.457) or 1-year risk for readmission (63.5% vs 63.3%; P = 0.774). In a Cox regression model, transplantation at the weekend was not associated with any increased risk for 1-year mortality, rehospitalization, or allograft failure/rejection.
  
  
  
  Deceased-donor kidney transplants performed at the weekend do not have inferior short-term outcomes on the basis of 1-year risk for rehospitalization, mortality, or allograft failure/rejection. Our data are reassuring for patients and professionals alike, but may also provide speculative insight into models of care that attenuate the weekend effect.
authors.affiliation: 1 Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, United Kingdom. 2 Department of Health Informatics, Queen Elizabeth Hospital, Edgbaston, Birmingham, United Kingdom. 3 School of Immunity and Inflammation, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Anderson
authors.forename: Jemma L
authors.initials: JL
authors.lastname: Mytton
authors.forename: Felicity
authors.initials: F
authors.lastname: Evison
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Ferro
authors.forename: Adnan
authors.initials: A
authors.lastname: Sharif
mesh_terms: D000328:Adult; D039602:After-Hours Care; D016009:Chi-Square Distribution; D016208:Databases, Factual; D004739:England; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006302:Health Services Research; D054625:Healthcare Disparities; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission; D010359:Patient Readmission; D017064:Process Assessment, Health Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome