Outcomes of Kidney Transplantation Using Deceased Diabetic Donors.
1Department of Nephrology, Houston Methodist Hospital, Houston, TX
2Department of Pathology and Genomic Medicine, Houston Methodist Research Institute, Houston, TX
Meeting: 2017 American Transplant Congress
Abstract number: A103
Keywords: Graft survival
Session Information
Date: Saturday, April 29, 2017
Session Name: Poster Session A: Deceased Donor Issues I: Allocation, KDPI and Recipient Selection
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Introduction: Histological reversal of diabetic lesions in transplanted kidney once euglycemia has been restored is well documented. Conversely, it is known that diabetes status in deceased donors increases risk for graft loss. We examined which subpopulation of recipients, non-diabetic vs diabetic, of a deceased diabetic donor kidney had a longer allograft and patient survival.
Methods: All adult recipients of deceased donor kidneys at Houston Methodist Hospital during 2006-2014 were included. Patients were subdivided into four groups based on recipient [R] and donor [D] diabetes status [DM vs. Normal (N)] . The groups were R-DM/D-DM, R-N/D-DM, R-DM/D-N, and R-N/D-N. Kaplan Meier and multivariate analyses was performed and Bayesian information criterion (BIC), C statistic and likelihood ratio test were used.
Results: 706 patients were included. R-DM/D-DM consisted of 23 patients, R-N/D-DM with 26 patients, R-DM/D-N with 211 and R-N/D-N 446 patients. Recipients of deceased diabetic kidneys tended to be males, of older age and higher BMI and received a kidney from older donors with higher BMI. Kaplan Meier analysis at 5 years showed an 8.5% patient mortality in R-N/D-N , 3.8% patient mortality in R-N/D-DM, 15.6% patient mortality in R-DM/D-N and a 21.7% mortality in R-DM/D-DM subgroup (P- value= 0.009). Multivariate analysis of patient mortality at 5 years showed that R-DM/D-DM subgroup had a hazard ratio of 3.14 for death compared to R-N/D-N (P-value= 0.034, 95% CI= 1.09-9.04). Kaplan Meier analysis at 5 years showed a graft survival of 83.4% in R-N/D-N, 92.3% graft survival in R-N/D-DM, 77.1% graft survival in R-DM/D-N and 66.6% graft survival in R-DM/D-DM (P-value= 0.165). Further comparison of R-N/D-N (comparator subgroup) with R-N/D-DM revealed that R-N/D-N patients had higher PRAs and longer dialysis duration time.
Conclusion: There is an increased risk of mortality associated with recipient's diabetic status compared to non-diabetics. Similarly, diabetic recipients of deceased diabetic donor kidney have a significant increase in mortality.
CITATION INFORMATION: Khan F, Suki W, Nguyen D, Graviss E. Outcomes of Kidney Transplantation Using Deceased Diabetic Donors. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Khan F, Suki W, Nguyen D, Graviss E. Outcomes of Kidney Transplantation Using Deceased Diabetic Donors. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-of-kidney-transplantation-using-deceased-diabetic-donors/. Accessed April 15, 2021.« Back to 2017 American Transplant Congress