Background: De novo Donor Specific Antibodies (DSA) are considered as a risk factor
for the kidney allograft outcomes in recipients after simultaneous liver-kidney transplantation
(SLKT). We hypothesized that length of hospital stay (LOS) might be associated with
de novo DSA development of due to the increased likelihood of receiving blood transfusions
with reduced immunosuppressive regimens. Methods: This study is a single-center, retrospective
cohort study consisting of 85 recipients who underwent SLKT from 2009 to 2018 in our
hospital. We divided the patients into two groups according to LOS [long hospital
stay (L) group (LOS >14 days) and short hospital stay (S) group (LOS <= 14 days)].
Propensity score (PS) has been created using logistic regression to predict LOS greater
than median of 14 days. The association between the presence of de novo DSA and LOS
was assessed by logistic regression models adjusted for PS. Results: The mean age
at transplantation of the entire cohort was 55.5 +/- 10.1 years. Sixty percent of
the recipients were male and Caucasian. Median LOS in (L) group was three-fold longer
than (S) group [L: median 30 days (IQR: 21-52), S: median 8.5 days (IQR: 7-11)]. Eight
patients developed de novo DSA after SLKT (9.4%), all of them were in (L) group. Longer
LOS was significantly associated with higher risk of development of de novo DSA in
unadjusted (OR+ each 5 days: 1.09, 95% CI:1.02-1.16) and PS adjusted (OR+ each 5 days:
1.11, 95% CI:1.02-1.21) analysis. Conclusion: Longer hospitalization is significantly
associated with the development of de novo DSA in SLKT.
