Impact of Deceased Donor Diabetes Mellitus on Kidney Transplant Outcomes: A Propensity Score-Matched Study

Ahmad, Mufazzal; Cole, Edward; Cardella, Carl J.; Cattran, Daniel C.; Schiff, Jeffrey; Tinckam, Kathryn; Kim, S Joseph

doi:10.1097/tp.0b013e3181ac68a9

Cited by 27 publications

(26 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Donor diabetes has been shown to be associated with inferior graft survival in kidney transplant recipients (27,28); however, the association of donor diabe-tes with liver transplant outcome is unclear. Donor diabetes has been shown to be associated with inferior graft survival in kidney transplant recipients (27,28); however, the association of donor diabe-tes with liver transplant outcome is unclear.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for New-Onset Diabetes Mellitus in Adult Liver Transplant Recipients, an Analysis of the Organ Procurement and Transplant Network/United Network for Organ Sharing Database

et al. 2010

View full text Add to dashboard Cite

OBJECTIVE.: To analyze the risk factors for new-onset diabetes mellitus (NODM) in liver transplant recipients using the Organ Procurement and Transplant Network/United Network for Organ Sharing database. METHODS.: Among 20,172 primary liver recipients (age > or =18 years) transplanted between July 2004 and December 2008 in Organ Procurement and Transplant Network/United Network for Organ Sharing databases, 15,463 recipients without pretransplant diabetes were identified. Risk factors for NODM were examined using multivariate Cox regression analysis. RESULTS.: NODM was reported in 26.4% of recipients (median follow-up, 685 days). Independent predictors of NODM development included recipient age (> or = 50 vs. <50 years, hazard ratio [HR]=1.241), African American race (HR=1.147), body mass index (> or = 25 vs. <25, HR=1.186), hepatitis C (HR=1.155), recipient cirrhosis history (HR=1.107), donor age (> or = 60 vs. <60 year, HR=1.152), diabetic donor (HR=1.151), tacrolimus (tacrolimus vs. cyclosporine, HR=1.236), and steroid at discharge (HR=1.594). Living donor transplant (HR=0.628) and induction therapy (HR=0.816) were associated with a decreased risk of NODM. CONCLUSION.: The incidence of NODM was 26.4% in liver recipients with a median follow-up time of 685 days. Identified risk factors for NODM in liver transplantation were similar to that in kidney transplantation. Some of the identified factors are potentially modifiable, including obesity and the choice of immunosuppressive regimens.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk Factors for New-Onset Diabetes Mellitus in Adult Liver Transplant Recipients, an Analysis of the Organ Procurement and Transplant Network/United Network for Organ Sharing Database

et al. 2010

View full text Add to dashboard Cite

show abstract

“…It allows simultaneous adjustments for multiple confounders (42)(43)(44). Traditionally, matching in observational cohort studies has been done manually.…”

Section: Discussionmentioning

confidence: 99%

Have We Changed the Outcome in Membranous Nephropathy? A Propensity Study on the Role of Immunosuppressive Therapy

Cattran

Reich

Kim

et al. 2011

Clinical Journal of the American Society of Nephrology

Self Cite

View full text Add to dashboard Cite

SummaryBackground and objectives The long-term effect of immunosuppressive therapy (IS) on kidney survival in idiopathic membranous nephropathy (MGN) is debated. The introduction of renin angiotensin blockade, rigorous BP control, and the increasing age at presentation of patients with MGN adds further uncertainty. Given these important changes, we sought to determine whether implementation of IS has altered outcome. Design, setting, participants, & methodsWe prospectively evaluated 280 incident MGN patients from three distinct 10-year periods starting from 1975. ResultsWe found expected changes in treatment regimens but also variations in age, renal function, severity of proteinuria, and BP at presentation over this time. Outcomes did not differ over time if these significant variations in clinical characteristics were not accounted for across the eras. The effect of IS in the 57 patients treated with currently recommended regimens was assessed using propensity adjustment to address selection bias and the effect of newer, conservative therapies. A propensity score estimating the probability of receiving IS permitted the pairing of 39 treated patients with controls with similar high risk of progression of clinical features. Using this approach, IS was associated not only with remissions in proteinuria but also with substantially improved renal survival. ConclusionsThe study confirms that patient presenting characteristics and management regimens have changed significantly over time and the natural history of MGN has been altered. A study of propensitymatched patients confirms that current recommendations for IS have improved outcomes in MGN patients at high risk of progression.

show abstract

“…Ahmad et al noted similar patient survival, but slightly inferior graft survival in recipients of deceased diabetic donor kidneys when compared to recipients of deceased non‐diabetic donor kidneys. Due to the small absolute difference, the authors concluded that diabetic donors could be used to expand the donor pool . In 2012, Mohan et al demonstrated that donor diabetes did not have a significant effect on graft and patient survival and even suggested that diabetic donor kidneys may be superior to using extended criteria donor kidney .…”

Section: Introductionmentioning

confidence: 99%

“…Due to the small absolute difference, the authors concluded that diabetic donors could be used to expand the donor pool. 3 In 2012, Mohan et al demonstrated that donor diabetes did not have a significant effect on graft and patient survival and even suggested that diabetic donor kidneys may be superior to using extended criteria donor kidney. 4 Recently, Cohen et al reported discordant recipient pair analysis of diabetic donor kidneys, using United Network of Organ Sharing data, and found that although a risk was associated with diabetic donor kidneys, it was dependent on recipient diabetes status.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of kidney transplantation using deceased donors with history of diabetes

Khan

Truong

Nguyen

et al. 2020

Clinical Transplantation

View full text Add to dashboard Cite

Deceased diabetic kidneys are increasingly utilized in transplantation. The relationship of donor's history of diabetes to clinical and histological outcomes was examined. Forty‐nine diabetic deceased donor kidneys (D‐DM) were transplanted into 26 normal (R‐N/D‐DM) and 23 diabetic recipients (R‐DM/D‐DM) and compared to 211 diabetic recipients of normal kidneys(R‐DM/D‐N) and 466 normal recipients of normal kidneys (R‐N/D‐N). Patient survival at 5 years was 89.7% in R‐N/D‐N, 96.2% in R‐N/D‐DM, 80.1% in R‐DM/D‐N, and a 71.6% in R‐DM/D‐DM (P = .008). Death‐censored graft survival at 5 years was 86.3% in R‐N/D‐N, 87.4% in R‐N/D‐DM, 93.5% in R‐DM/D‐N, and 87.5% in R‐DM/D‐DM (P = .24). Multivariable regression analysis showed that compared to non‐diabetic recipients, diabetic recipients had a 2‐ to 3‐fold increased risk of mortality. In this cohort, there was no impact on death‐censored graft survival of diabetic donor status. Only 6 of 26 post‐perfusion biopsies showed evidence of diabetic nephropathy (

show abstract

Impact of Deceased Donor Diabetes Mellitus on Kidney Transplant Outcomes: A Propensity Score-Matched Study

Cited by 27 publications

References 28 publications

Risk Factors for New-Onset Diabetes Mellitus in Adult Liver Transplant Recipients, an Analysis of the Organ Procurement and Transplant Network/United Network for Organ Sharing Database

Risk Factors for New-Onset Diabetes Mellitus in Adult Liver Transplant Recipients, an Analysis of the Organ Procurement and Transplant Network/United Network for Organ Sharing Database

Have We Changed the Outcome in Membranous Nephropathy? A Propensity Study on the Role of Immunosuppressive Therapy

Outcomes of kidney transplantation using deceased donors with history of diabetes

Contact Info

Product

Resources

About