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New Onset Diabetes after Transplant (NODAT) in Hispanic Kidney Transplant Recipients: A Multi-Center Retrospective Study

R. Alsheikh1, L. Kodali2, O. Alfayez3, M. Alshibani1, A. Basilim1, M. Fazel4

1King Abdulaziz University, Jeddah, Saudi Arabia, 2Mayo Clinic, Scottsdale, AZ, 3Qassim University, Buraydah, Saudi Arabia, 4University of Arizona, Tucson, AZ

Meeting: 2020 American Transplant Congress

Abstract number: D-028

Keywords: Hispanic, Kidney transplantation, Post-transplant diabetes

Session Information

Session Name: Poster Session D: Kidney: Cardiovascular and Metabolic Complications

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Hispanic ethnicity is one of the reported risk factors for NODAT in kidney transplant recipients (KTR). The purpose of our study is to determine the incidence of NODAT in Hispanic KTR compared with non-Hispanics over 3 years of follow up.

*Methods: Our study is a multi-center retrospective study which included adult KTR who were transplanted during the period between January 2013 and December 2016 in two transplant centers. The study included recipients who were first-time kidney transplants, not known as diabetic pre-transplant, started on tacrolimus; mycophenolate and steroids for maintenance and had a minimal follow up of 12-months post-transplant. The primary outcome was the incidence of NODAT (defined as the use of anti-diabetic medications starting after 3 months post-transplant with no history of diabetes before transplant)among Hispanic KTR at 1,2,and 3 years post-transplant compared with non-Hispanics.The secondary outcomes were patient survival, graft survival, biopsy-proven acute rejection (BPAR),Cytomegalovirus (CMV) infection, BK viremia, serum creatinine (SCr) and tacrolimus level at 1,2 and 3 years post-transplant; in addition to, the impact of reported predictors ( i.e. recipient age at transplant, Family history of diabetes, body mass index, BPAR, recipient hepatitis C positive serology, number of HLA mismatches, male gender and hispanic ethnicity) on the incidence of NODAT at 1-year post-transplant.

*Results: Only 338 (out of 811) KTR met the study criteria. Hispanics (n=121) were younger than non-Hispanics(n=217)(46.06±14.18; 51.83±12.86,p<0.001). Around 62% of Hispanics have a family history of diabetes (p=0.0001). Around 25% of non-Hispanics were at high risk for CMV infection D+/R– (p=0.001).Otherwise,the two groups have similar baseline characteristics. At 1-year post-transplant, there was no significant difference in the incidence of NODAT (~6% in each group) and the other outcomes except for SCr level (p=0.027). At 2-year post-transplant, the incidence of NODAT was significantly higher in Hispanics compared with non-Hispanics (n=7/63 (11.11%),n=4/123 (3.25%);p=0.046). However, there was no significant differences in the other outcomes. At 3-year post-transplant, there was no significant difference in the outcomes between the two groups. Using Cox regression, none of the analyzed predictors, including Hispanic ethnicity, had a significant effect on the incidence of NODAT at 1-year post-transplant.

*Conclusions: Our study suggests that at 1-year post-transplant, Hispanic ethnicity does not increase the incidence of NODAT in KTR. Further studies are needed to confirm the results.

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To cite this abstract in AMA style:

Alsheikh R, Kodali L, Alfayez O, Alshibani M, Basilim A, Fazel M. New Onset Diabetes after Transplant (NODAT) in Hispanic Kidney Transplant Recipients: A Multi-Center Retrospective Study [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/new-onset-diabetes-after-transplant-nodat-in-hispanic-kidney-transplant-recipients-a-multi-center-retrospective-study/. Accessed May 11, 2025.

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