South Asians (SA) have a higher risk for cardiovascular disease and diabetes than the general population, but in renal transplant recipients, data are limited and controversial. The purpose of our study was to investigate the impact of SA ethnicity on Post-Transplantation Diabetes Mellitus (PTDM) incidence and patient survival after renal transplantation.

In this retrospective single centre study, the largest of its kind, we report the outcomes of 1184 patients (733 males, 451 females, mean age 48.3±13.1 yrs, mean follow up 56.6±30 months), receiving a steroid-sparing, tacrolimus based regime after monoclonal antibody induction. Steroids were stopped 7 days post-transplantation and only introduced to treat rejection. 591 patients were Caucasians (49.9%), 330 patients were of SA ethnicity (27.9%) and 143 were Afro-Caribbeans (AC) (12.1%). There was no difference regarding gender (p=0.701). SA patients were less likely to undergo pre-emptive transplantation (p<0.001) and to receive a kidney from a live donor (p<0.001). In addition, they were older (p=0.001), more likely to be diabetic before transplantation (p<0.001) and to develop PTDM (p<0.001). There were more deaths in SA group, but this was not significant (p=0.059). In survival analysis, there was a trend for increased mortality for SA patients (log rank p=0.059). SA ethnicity increased the risk of PTDM (log rank p<0.001). In Cox-regression, older age (p=0.025), months on dialysis (p=0.028), SA ethnicity (0.037) and pre-transplantion diabetes (p=0.003) increased the risk of death. Older age (p<0.001), steroid use (p<0.001), SA (p<0.001) and AC ethnicity (p=0.004) increased the risk of PTDM. SA ethnicity is an independent risk factor of PTDM and death. This group merits additional study to reduce these risks.

« Back to 2015 American Transplant Congress