Renal Transplantation Is Associated with Increased Complications Following Spinal Fusion Operations: Analysis of a National Database

Background Improved postoperative care for renal transplant recipients has advanced both duration and overall quality of life. However, degenerative spinal pathology is increasingly prevalent after transplant. Outcomes following spinal fusion among the renal transplant population in the United States are rarely addressed. Methods The Healthcare Cost and Utilization Project National Inpatient Sample database was employed. Cases in years 2008–2014 for patients ≥18 years old receiving spinal fusion, exploration/decompression, and/or spinal revision/re-fusion surgeries were included. Cases were divided into kidney transplant recipients (KTR) and non–kidney transplant recipients. Complications, demographics, and socioeconomic outcomes were compared between cohorts. Results Of 579,726 patients who met inclusion criteria, 685 (0.1%) were KTRs. The KTR population was older and included more men compared with the non–kidney transplant recipient population (60.1 years vs. 56.6 years, P Conclusions History of renal transplant was associated with increased inpatient medical and socioeconomic complications following spinal fusion. Physicians and patients must understand and respect the potentially increased perioperative challenges facing KTRs.