Does a History of Diabetes in Deceased Donors Modify the Outcomes of Kidney Transplant Recipients With Diabetes?
Division of Nephrology and the Multi-Organ Transplant Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Meeting: 2015 American Transplant Congress
Abstract number: 40
Keywords: Kidney transplantation
Session Information
Session Name: Concurrent Session: Kidney Complications: Late Graft Failure
Session Type: Concurrent Session
Date: Sunday, May 3, 2015
Session Time: 2:15pm-3:45pm
Presentation Time: 3:27pm-3:39pm
Location: Terrace IV
Background: The outcomes of kidneys from deceased donors with diabetes mellitus (dDM+) transplanted into recipients with DM (rDM+) have not been well studied.
Methods: A cohort study of U.S. deceased donor kidney transplant recipients from 1 Jan 2000 to 31 Dec 2009 was conducted using data from the Scientific Registry of Transplant Recipients (SRTR). The Kaplan-Meier method was used to assess total graft failure, death-censored graft failure, death with graft function, and total mortality by donor and recipient DM status. Cox proportional hazards models were fitted to examine the independent association of recipient DM status and time-to-event outcomes across donor DM strata.
Results: A total of 67,815 patients (of whom 1,404 were dDM+/rDM+) were included in the study cohort. In general, dDM+/rDM+ patients were older, had shorter waiting times, larger BMI, and higher Kidney Donor Risk Indices compared to the other donor/recipient DM combinations. Kaplan-Meier survival estimates revealed that recipient DM was the main driver of mortality while donor DM was the main driver of graft loss. Interestingly, the relative hazard of death with graft function or total mortality by recipient DM status was higher in non-DM (vs. DM) deceased donors (Table). There was no significant relationship observed between recipient DM status and death-censored graft failure regardless of donor DM status (Table). Total graft failure results mirrored the mortality endpoints.
Conclusion: Transplanting kidneys from a selected population of deceased donors with DM into recipients with (vs. without) DM does not increase the relative hazard of graft loss or death beyond the effect of recipient DM alone. These results have implications for the expanded use of kidneys from deceased donors with DM.
| Outcome | Donor DM Status | HR for DM vs. No DM in Recipients | P Value for Interaction |
| Total Graft Failure | No DM | 1.42 (1.37, 1.46) | 0.06 |
| DM | 1.27 (1.14, 1.42) | ||
| Death-Censored Graft Failure | No DM | 1.04 (0.99, 1.09) | 0.84 |
| DM | 1.05 (0.91, 1.22) | ||
| Death with Graft Function | No DM | 1.97 (1.88, 2.07) | 0.04 |
| DM | 1.66 (1.41, 1.96) | ||
| Total Mortality | No DM | 1.90 (1.82, 1.98) | 0.02 |
| DM | 1.61 (1.40, 1.85) |
To cite this abstract in AMA style:
Rajan T, Kim J. Does a History of Diabetes in Deceased Donors Modify the Outcomes of Kidney Transplant Recipients With Diabetes? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/does-a-history-of-diabetes-in-deceased-donors-modify-the-outcomes-of-kidney-transplant-recipients-with-diabetes/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress