Impact of NODAT on Post-Transplant Survival – An Analysis of UNOS Data.
University Hospital Cleveland Medical Center, Cleveland
Meeting: 2017 American Transplant Congress
Abstract number: C100
Keywords: Heart, Post-transplant diabetes
Session Information
Session Name: Poster Session C: Hearts and VADS: All Topics
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: New Onset Diabetes After Transplantation (NODAT) is common and may adversely affect long-term patient survival. Impact of NODAT on patient survival in heart transplantation is unknown.
Methods: Adult heart transplant recipients between January 2005, and September 2014 in United States were analyzed from the UNOS database. Incidence, time to development of NODAT, and impact of NODAT on long term patient survival were studied by utilizing Extended Kaplan Meier and Cox Proportional Hazards methods.
Results: 2471 out of 10, 847 (22.8%) patients (that were considered for analysis), developed NODAT at median follow up of 2.8 years (3 days- 9.6 years). Overall, 8.7%, 20.2%, and 27% of patients developed NODAT at 1 year, 2 year, and 5 years after follow up.
Overall, 1804/10847 (16.6%) of patients died at a median follow up of almost 4 years (3 days- 9.6 years). Patient survival was 96% at 1 year, 89% at 3 years, and 83% at 5 years of follow up. Extended Kaplan Meier curves for overall patient survival, stratified by NODAT as a time-dependent covariate are shown in figure below. 
Table below illustrates unadjusted, and adjusted hazard ratios for overall mortality for NODAT as a time-dependent covariate using extended Cox models.
| Model | Hazard Ratio For Mortality | p-value | 95 CI |
| 1- Unadjusted | 1.19 | 0.005 | 1.05-1.33 |
| 2- Adjusted for age, gender and race | 1.18 | 0.01 | 1.05-1.33 |
| 3- Adjusted for age, gender, race, and many other variables | 0.98 | 0.81 | 0.8-1.18 |
| 4- Adjusted for all variables in # 3 but not acute rejection | 1.18 | 0.01 | 1.04-1.34 |
| 5- Model 3 but with interaction between NODAT and acute rejection | |||
| NODAT alone from Model 5 | 1.29 | 0.001 | 1.11-1.51 |
| NODAT and Acute Rejection from Model 5 | 1.73 | – | – |
Conclusion: NODAT after heart transplantation is high. NODAT is associated with worse long term mortality after NODAT. Specifically patients with NODAT and acute rejection have far worse mortality than having nether of those complications.
CITATION INFORMATION: Sarabu N, Deo S, Park S. Impact of NODAT on Post-Transplant Survival – An Analysis of UNOS Data. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Sarabu N, Deo S, Park S. Impact of NODAT on Post-Transplant Survival – An Analysis of UNOS Data. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-nodat-on-post-transplant-survival-an-analysis-of-unos-data/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress