Session Name: Heart and VADs: All Topics
Session Date & Time: None. Available on demand.
*Purpose: The purpose of this study is to investigate New Onset Diabetes After Transplantation (NODAT) incidence and its impact on post-transplant prognosis in adult heart recipients. The study examines the effect of NODAT on mortality and graft failure. NODAT Risk factors were also investigated.
*Methods: For this retrospective cohort study with secondary data analysis, we evaluated the United Network for Organ Sharing registry adults older than 18 years old who had heart transplant without multi organ transplant or re-transplantation of the heart. We analyzed heart transplants that were conducted between January 2004 and December 2015 for mortality and graft failure. Post-transplant follow-up data collected up to Dec 2019 was used to evaluate transplantation outcomes. Cox proportional hazard regressions with multi-variable adjustment were calculated. Competing risk analysis with death was performed for graft failure outcome.
*Results: There was a total of 7,863 heart transplant recipients who did not have diabetes prior to transplantation. The incidence of NODAT was 19%. Median time to develop NODAT was 376 days for 1,485 patients. The NODAT group was older, had more African-American & Hispanic, had fewer college degrees, and received more intense steroid treatment. After multivariate adjustment, the NODAT group demonstrated a higher risk for both mortality (HR 1.05, p 0.323) and graft failure (SHR 1.05, p 0.403), but this was not statistically significant. Duration of tacrolimus and cyclosporine treatments were not related to worse outcomes in our study. This study also shows that risk factors for NODAT include steroid usage for rejection (SHR 1.74, p 0.001), anti-lymphocyte receptor antibody treatment for rejection (SHR 1.99, p 0.018), African-American race (SHR 1.39, p 0.001), post-transplant malignancy (SHR 1.18, p 0.029), and more than 1 year of steroid maintenance treatment (SHR 1.30, p 0.004).
*Conclusions: This large study evaluating the impact of NODAT on heart transplantation outcomes found an increased risk of graft failure and mortality, but not at a statistically significant level. This negative outcome must be taken into consideration for duration of immunosuppressant treatment and the prevention of NODAT.
To cite this abstract in AMA style:Kang W, Keattiyoat W, Kim M, Bhardwaj C. Impact of New Onset Diabetes After Transplantation on Heart Transplant Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-new-onset-diabetes-after-transplantation-on-heart-transplant-recipients/. Accessed June 20, 2021.
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