Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Little is known regarding optimizing waitlist management of end stage renal disease to improve post-transplant outcomes. Active vitamin D is associated with improved outcomes in hemodialysis, and has a distinctly long biologic half-life (15 days) as compared to its pharmacologic half-life (15 hours). There are no studies examining the effects of active vitamin D administered pre-transplant on immediate post-transplant outcomes.
*Methods: We performed a single-center retrospective analysis of active vitamin D usage pre-transplant on immediate post-transplant outcomes in 101 consecutive renal transplant recipients from April 2015 to October 2018 for whom pre-transplant dialysis data was available.
*Results: 38 of the 101 kidney transplant recipients received paricalcitol in the month before transplant, with a mean dose 21.82 +/- 9.87 mcg/week. Neither pre-transplant PTH nor calcium significantly differed between groups (Graph 1). Post-transplant serum calcium was significantly higher in the paricalcitol treated group (Graph 2). There was no significant difference in the incidence of DGF in patients treated with paricalcitol 17/38 (44%) versus no paricalcitol 25/59 (42%). However, LOS was significantly increased in the group who received paricalcitol, 10.74 +/- 9.66 days versus 7.5 +/- 3.36 days, p = 0.009. Linear regression evaluating effect of recipient age, deceased cardiac death donor, kidney donor profile index, cold ischemia time, dialysis vintage, DGF, and dose of paricalcitol per week in the month prior to transplant found only DGF (OR 3.617, 95% CI 0.748-6.487, p = 0.014) and paricalcitol pre-transplant (OR 3.526, 95% CI 0.794-6.257, p = 0.012) to be significantly associated with transplant admission LOS. This may be driven by a weak trend toward increased rate of infection in the group that had received paricalcitol (7.9% versus 1.6%, p = 0.11).
*Conclusions: Active vitamin D use prior to transplant may negatively affect post-transplant outcomes. More studies are needed to understand the effect of pre-transplant discontinuation of active vitamin D therapy.
To cite this abstract in AMA style:Dahabreh LAl, Abou-Mitri C, Negrea L, Chavin K, Srinivas T, Padiyar A. Active Vitamin D Prior to Transplant Affects Post-Transplant Outcomes [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/active-vitamin-d-prior-to-transplant-affects-post-transplant-outcomes/. Accessed February 27, 2021.
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