Outcomes of living donor kidney transplantation in diabetic patients: age and sex matched comparison with non-diabetic patients

Abstract

Background/AimsKidney transplantation (KT) reportedly provides a significant survival advantage over dialysis in diabetic patients. However, KT outcome in diabetic patients compared with that in non-diabetic patients remains controversial. In addition, owing to recent improvements in the outcomes of KT and management of cardiovascular diseases, it is necessary to analyze outcomes of recently performed KT in diabetic patients.MethodsWe reviewed all diabetic patients who received living donor KT between January 2008 and December 2011. Each patient was age- and sex-matched with two non-diabetic patients who received living donor KT during the same period. The outcomes of living donor KT were compared between diabetic and non-diabetic patients.ResultsAmong 887 patients, 89 diabetic patients were compared with 178 non-diabetic patients. The incidence of acute rejection was not different between the diabetic and non-diabetic patients. Urinary tract infection and other infections as well as cardiovascular events occurred more frequently in diabetic patients. However, diabetes, cardiovascular disease, and infection were not significant risk factors of graft failure. Late rejection (acute rejection after 1 year of transplantation) was the most important risk factor for graft failure after adjusting for diabetes mellitus (DM), human leukocyte antigen mismatch, rejection and infection (hazard ratio, 56.082; 95% confidence interval, 7.169 to 438.702; p < 0.001). Mortality was not significantly different between diabetic and non-diabetic patients (0 vs. 2, p = 0.344 by log-rank test).ConclusionsEnd-stage renal disease patients with DM had favorable outcomes with living donor kidney transplantation.

In‐hospital outcomes for solid organ transplants according to type 2 diabetes status: An observational, 15‐year study in Spain

“…We detected that infection was more often coded in people without diabetes, except for kidney transplant, and graft complications were more frequent among people without diabetes for all types of transplants. Both older and recent reports describe a higher short‐term infection rate after kidney transplant in people with type 2 diabetes, too . However, we do not have straightforward explanations for the rest of the findings.…”

Pulmonary Artery Systolic Pressure Measured Intraoperatively by Right Heart Catheterization Is a Predictor of Kidney Transplant Recipient Survival

“…However, Baek et al assessed clinical outcomes after living donor kidney transplantation in patients with diabetes compared to non-diabetic patients. The incidence of acute rejection, death-censored graft failure, non-death-censored graft failure, and mortality were not significantly different between patients with and without diabetes after living donor kidney transplantation [26]. Nevertheless, we are aware of this limitation in our study, and a well-designed prospective clinical trial is needed to assure accurate randomization and minimize the effect of such clinical variables on the clinical outcome.…”

Clinical Outcomes of ABO-Incompatible Kidney Transplantation in Patients with End-Stage Kidney Disease due to Diabetes Nephropathy

“…On the other hand, Baek et al [28] reported that there were no significant changes in the rates of rejection between diabetic and non-diabetic recipients. Some authors suggested that patients with diabetes were rendered susceptible to cellular rejection because of their significant risk of exacerbation of glycemic control after transplantation and that strict glycemic control might be important [4, 28]. In this study, glycemic control was relatively good because of the less than 7.0% HbA1c levels, which the Japan Diabetes Society recommends in order to avoid diabetic complications.…”