Kidney-pancreas transplant recipients experience higher risk of complications compared to the general population after undergoing coronary artery bypass grafting

Background: This retrospective analysis aims to identify differences in surgical outcomes between pancreas and/or kidney transplant recipients compared to the general population undergoing CABG. Methods: Using NIS data from 2005 to 2014, patients who underwent CABG were stratified by either no history of transplant, or history of pancreas and/or kidney transplant. Multivariate analysis was used to calculate odds ratio (OR) to evaluate in-hospital mortality, morbidity, length of stay (LOS), and total hospital charge in all centers. Results: Overall, 2,678 KTx, 184 PTx, 254 KPTx, and 1,796,186 Non-Tx met inclusion criteria. KPTx experienced higher complication rates compared to Non-Tx (78.3% vs. 47.8%, p<0.01). Those with PTx incurred greater total hospital charge and LOS. On weighted multivariate analysis, KPTx was associated with an increased risk for developing any complication following CABG (OR 3.512, p<0.01) and emergency CABG (3.707, p<0.01). This risk was even higher at transplant centers (CABG OR 4.302, p<0.01; emergency CABG OR 10.072, p<0.001). KTx was associated with increased in-hospital mortality following emergency CABG, while PTx and KPTx had no mortality to analyze. Conclusion: KPTx experienced a significantly higher risk of complications compared to the general population after undergoing CABG, in both transplant and non-transplant centers. These outcomes should be considered when providing perioperative care.