Post-Transplant Infections Drive Early Readmissions : Liver Transpl | Apr 2026

Introduction:

Hospital readmission within 30 days of liver transplantation is a common and costly event that reflects early postoperative morbidity and is increasingly used as a quality metric in transplant care. Early readmissions place substantial burdens on patients and healthcare systems and have been associated with worse long-term outcomes. However, predictors of readmission have varied across studies, limiting the development of effective preventive strategies.

Problem Statement:

Most previous studies examining post-transplant readmissions have been limited by single-center experience or administrative datasets, making it difficult to identify consistent and actionable risk factors. Understanding the causes and predictors of early readmission is essential for improving post-transplant care and reducing avoidable healthcare utilization.

Summary:

Using the national TransQIP registry, this study evaluated patterns and determinants of unplanned 30-day readmission after deceased donor liver transplantation. The investigators found that early readmission was common, affecting more than two-fifths of transplant recipients. Most readmissions were relatively short and were not primarily driven by procedural complications, suggesting that medical issues remain the dominant cause of rehospitalization during the early post-transplant period. The most important finding was the strong association between post-discharge infectious complications and readmission risk. Organ-space surgical site infections emerged as the strongest predictor, followed by sepsis and urinary tract infections. These observations highlight infection prevention, early detection, and prompt outpatient management as critical targets for reducing readmissions after liver transplantation. In contrast, better pre-existing functional status was independently associated with a lower likelihood of readmission, emphasizing the importance of patient conditioning and functional recovery. The study also identified distinct risk profiles for different infection types, suggesting opportunities for more personalized post-discharge monitoring strategies. Overall, these findings indicate that many early readmissions may be preventable through focused infection surveillance, optimized discharge planning, and enhanced outpatient follow-up. The results provide important national-level evidence supporting targeted interventions aimed at reducing infectious complications and improving early outcomes after liver transplantation.