Impact of Kidney and Liver Transplant Following Blunt Trauma: A Propensity-Matched National Database Study

Abstract

Background

Transplant recipients represent a growing population with unique medical complexities, yet trauma outcomes remain poorly characterized. We investigated mortality and complications in kidney transplant (KT) and liver transplant (LT) patients following blunt trauma.

Methods

The Healthcare Cost and Utilization Project National Inpatient Sample (2019-2022) was queried for adults admitted following blunt trauma. ICD-10 codes identified KT/LT patients. Propensity score matching controlled for confounders.

Results

1,117,744 patients were included 2237 (0.20%) KT and 1250 (0.11%) LT. No mortality differences were observed. After matching, KT patients had lower renal failure risk (OR 0.83, 95% CI: 0.72-0.95, P = .007) and higher risk of pneumonia (OR 1.41, 95% CI: 1.09-1.82, P = .009). LT patients had higher renal failure risk (OR 1.56, 95% CI: 1.31-1.87, P < .001).

Conclusion

Transplant recipients experienced mortality rates comparable to matched controls after controlling for hospital characteristics and patient-level confounders. However, organ-specific specific vulnerabilities were identified: KT recipients demonstrated significantly increased pneumonia risk (OR 1.41), while LT recipients had 56% increased odds of renal failure. These associations may inform future investigation into targeted monitoring strategies and interventions for this population.