Original InvestigationTransplantationAssociations of Pretransplant Diabetes Mellitus, New-Onset Diabetes After Transplant, and Acute Rejection With Transplant Outcomes: An Analysis of the Organ Procurement and Transplant Network/United Network for Organ Sharing (OPTN/UNOS) Database
Section snippets
Study Design, Setting, and Population
Adult recipients (aged ≥18 years) who had received their primary kidney transplant between July 1, 2004, and December 31, 2007, with at least 1 follow-up report with a clear record of DM status during follow-up were identified in the OPTN/UNOS database as of May 22, 2009. Multiorgan transplant recipients and recipients without clear reports of pretransplant diabetic status were excluded. Recipients surviving with a functioning transplant for at least 1 year posttransplant were identified and
Demographic Data
In the original sample of 45,989 adult recipients who received a primary kidney transplant alone between July 2004 and December 2007, the prevalence of pretransplant DM was 32.3% (14,857 of 45,989). NODAT was identified during the first year after transplant in 4,449 of 31,132 recipients (14.3%) who did not have DM before transplant, which corresponds to 9.7% of all study patients. Cumulative incidences of NODAT at 12, 24, and 36 months posttransplant were 9.7%, 13.3%, and 16.4%, respectively.
Discussion
In the present study, we analyzed the differential impacts of acute rejection, pretransplant DM, and NODAT on transplant and patient survival in the recent cohort (underwent transplant between 2004 and 2007) of kidney transplant recipients who survived with a functioning transplant for at least 1 year in the United States. In our study population, the reported rate of pretransplant DM was 31.5%. The reported rate of acute rejection at 1 year posttransplant was 9.7%, and that of NODAT at 1 year
Acknowledgements
The data and analyses reported in the 2008 Annual Report of the US OPTN and the Scientific Registry of Transplant Recipients have been supplied by UNOS and Arbor Research under contract with the Department of Health and Human Services/Health Resources and Services Administration (contract 231-00-0115). The authors alone are responsible for reporting and interpreting these data; the views expressed herein are those of the authors and not necessarily those of the US Government.
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2021, Transplantation ReportsCitation Excerpt :Another single center study identified NODAT as an independent predictor of increased mortality when compared to patients without diabetes after 8.3 years of follow-up [7]. In a large retrospective analysis of OPTN/UNOS data, a significantly higher first-year acute rejection rate in NODAT (14.7%) compared to patients with pre-existing diabetes (9.0%) and nondiabetics (9.6%) was observed [5]. Despite significant improvements in one-year allograft and patient survival and outcomes, advancements in long-term outcomes have been unsatisfactory [14].
Post-transplant allograft outcomes according to mismatch between donor kidney volume and body size of recipients with pre-transplant diabetes mellitus
2021, Diabetes Research and Clinical PracticeCitation Excerpt :As secondary outcomes of our study, cardiovascular complication rates were higher in the pre-transplant DM groups. In previous studies, pre-transplant DM was reported as a significant risk factor for major cardiovascular events and cardiovascular mortality in kidney recipients [29,33]. Our findings are consistent with these studies.
Originally published online as doi:10.1053/j.ajkd.2010.06.027 on October 11, 2010.