Incidence of New-onset Diabetes Mellitus and Association with Mortality in Childhood Solid Organ Transplant Recipients: a Population-based Study

Overview

Journal Nephrol Dial Transplant

Publisher Oxford University Press

Specialties General Surgery
Nephrology

Date 2018 Jul 31

PMID 30060206

Citations 2

Authors

Rahul Chanchlani

Sang Joseph Kim

Stephanie N Dixon

Vanita Jassal

Tonny Banh

Karlota Borges

Jovanka Vasilevska-Ristovska

John Michael Paterson

Vicky Ng

Anne Dipchand

Melinda Solomon

Diane Hebert

Rulan S Parekh

Affiliations

Soon will be listed here.

Abstract

Background: Precise estimates of the long-term risk of new-onset diabetes and its impact on mortality among transplanted children are not known.

Methods: We conducted a cohort study comparing children undergoing solid organ (kidney, heart, liver, lung and multiple organ) transplant (n = 1020) between 1991 and 2014 with healthy non-transplanted children (n = 7 134 067) using Ontario health administrative data. Outcomes included incidence of diabetes among transplanted and non-transplanted children, the relative hazard of diabetes among solid organ transplant recipients, overall and at specific intervals posttransplant, and mortality among diabetic transplant recipients.

Results: During 56 019 824 person-years of follow-up, the incidence rate of diabetes was 17.8 [95% confidence interval (CI) 15-21] and 2.5 (95% CI 2.5-2.5) per 1000 person-years among transplanted and non-transplanted children, respectively. The transplant cohort had a 9-fold [hazard ratio (HR) 8.9; 95% CI 7.5-10.5] higher hazard of diabetes compared with those not transplanted. Risk was highest within the first year after transplant (HR 20.7; 95% CI 15.9-27.1), and remained elevated even at 5 and 10 years of follow-up. Lung and multiple organ recipients had a 5-fold (HR 5.4; 95% CI 3.0-9.8) higher hazard of developing diabetes compared with kidney transplant recipients. Transplant recipients with diabetes had a three times higher hazard of death compared with those who did not develop diabetes (HR 3.3; 95% CI 2.3-4.8).

Conclusions: The elevated risk of diabetes in transplant recipients persists even after a decade, highlighting the importance of ongoing surveillance. Diabetes after transplantation increases the risk of mortality among childhood transplant recipients.

Citing Articles

"Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022." Survival analysis.

Calvo-Herrera M, Serna-Campuzano A, Isaza-Lopez M, Villegas-Arbelaez E, Rojas-Rosas L, Serna-Higuita L BMJ Paediatr Open. 2024; 8(1).

PMID: 39725454 PMC: 11683984. DOI: 10.1136/bmjpo-2024-002710.

LASSO-derived nomogram predicting new-onset diabetes mellitus in patients with kidney disease receiving immunosuppressive drugs.

Shao L, Luo C, Yuan C, Ye X, Zeng Y, Ren Y J Clin Pharm Ther. 2022; 47(10):1627-1635.

PMID: 35791031 PMC: 9796007. DOI: 10.1111/jcpt.13713.

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