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. 2025 Jan;39(1):e70081.
doi: 10.1111/ctr.70081.

Does Weekend Discharge Affect Readmission and Survival in Liver Transplant Patients? Insights From a Cohort Study

Ayato Obana  1 , Miho Akabane  1 , Hannah Chi  2 , Nolan Ladd  2 , Matthew Yoder  2 , Lily Kaufman  2 , Rithin Punjala  1 , Kejal Shah  1 , Matthew Hamilton  1 , Ashley Limkemann  1 , Austin Schenk  1 , Navdeep Singh  1 , Black Slyvester  1 , Khalid Mumtaz  3 , Kenneth Washburn  1 , Musab Alebrahim  1
Affiliations

Does Weekend Discharge Affect Readmission and Survival in Liver Transplant Patients? Insights From a Cohort Study

Ayato Obana et al. Clin Transplant. 2025 Jan.

Abstract

Background: Weekend hospital discharges are often associated with reduced staffing, potentially impacting the quality of patient care. We studied the effects of weekend discharge after liver transplantation (LT) on early readmission rates, overall survival (OS), and graft survival (GS).

Method: We analyzed data from the Ohio State University Wexner Medical Center database (January 2016 to December 2023). The study included initial LT recipients (LTRs) including donation after brain death (DBD) and donation after cardiac death (DCD). Primary outcomes encompassed early readmission rates, and secondary outcomes included OS and GS.

Results: The cohort comprised 915 LTRs (645 DBD, 270 DCD), with 156 (17.0%) weekend and 759 (83.0%) weekday discharges. Regarding discharge disposition, 681 (74.4%) patients were discharged home, 210 (22.9%) were discharged to healthcare facilities. No significant differences were identified in the length of hospital stay (8 days vs. 9 days, weekend vs. weekday, respectively, p = 0.22) or 30-day readmission (29.5% vs. 32.5%, weekend vs. weekday, respectively, p = 0.75). There were no significant differences in OS (90.9% vs. 92.7% at 1-year, 84.4% vs. 88.0% at 3-year, weekend vs. weekday, p = 0.27) and GS (90.9% vs. 91.5% at 1-year, 84.0% vs. 86.6% at 3-year, weekend vs. weekday, p = 0.50). Multivariate logistic analysis showed no significant impact of weekend discharge (OR: 0.84 [0.57-1.22], p = 0.35) or discharge disposition (OR: 1.00 [0.75-1.33], p = 1.00) on 30-day readmission. Multivariate Cox regression analysis found no significant impact of weekend discharge or discharge disposition on OS and GS (all p > 0.05).

Conclusion: Weekend discharge does not impact early readmission, OS, or GS in LTRs. These findings are a testament to our multidisciplinary team efforts and suggest that with appropriate discharge planning and follow-up care, the timing of discharge may be less critical than previously assumed.

Keywords: graft survival; liver transplantation; overall survival; readmission rates; weekend discharge.

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