Incidence of Post-Transplant Hyperglycemia and New-Onset Diabetes After Transplantation (NODAT) in Pediatric Solid Organ Transplant (SOT) Recipients.: Abstract# A486 : Transplantation

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Poster Sessions: All Organs: The World Transplant Congress 2014 Abstract Supplement is jointly published by the American Journal of Transplantation and Transplantation on behalf of the American Society of Transplant Surgeons, The Transplantation Society and the American Society of Transplantation.: Pediatric: Other: Sunday, July 27, 2014: 6: 30 PM - 8: 00 PM: Exhibit Hall

Incidence of Post-Transplant Hyperglycemia and New-Onset Diabetes After Transplantation (NODAT) in Pediatric Solid Organ Transplant (SOT) Recipients.

Abstract# A486

Chanchlani, R.1; Choi, J.1; Vasilevska-Ristovska, J.1; Ng, V.1; Dipchand, A.1; Solomon, M.1; Hebert, D.1; Kim, S.2; Parekh, R.1,2

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1Hospital for Sick Children, Toronto, ON, Canada;

2University Health Network, Toronto, ON, Canada.

Transplantation 98():p 238, July 15, 2014.
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Background: NODAT following SOT is associated with cardiovascular morbidity, poor graft function and patient survival. The incidence of NODAT within first year post-transplant in adults is 15-20% in renal and 10-30% in liver transplant recipients. The incidence of post-transplant hyperglycemia and NODAT after pediatric SOT remains uncertain.

Objective:To determine the incidence of post-transplant hyperglycemia and NODAT in pediatric SOT and the risk per individual organ group.

Methods: All children who underwent SOT from January 1st,2002 to December 31st,2011 were followed till the time of transfer (age of 18 years) or death. Post-transplant hyperglycemia was defined as random blood glucose levels >11.1 mmol/l on two occasions after 14 days of transplant, not requiring further treatment. NODAT was defined according to the American Diabetes Association criteria, requiring treatment. Analyses were performed using the Kaplan-Meier method and Cox proportional hazards model.

Results: Of 459 children, 259 (56.4%) were boys. The population included liver (32.2%), kidney (32%), heart (27.9%), lung (5.4%), and multiple organ (2.4%) transplant recipients. During a mean follow-up of 3.7±2.8 years (median:3.2), 73 (15.9%) recipients developed post-transplant hyperglycemia and 12 (2.6%) progressed to NODAT. The highest incidence of hyperglycemia was seen in multiple organ (54.5%), followed by lung (28%), renal (16.3%), heart (14.1 %), and liver (12.1 %) transplant recipients. The relative hazard for post-transplant hyperglycemia was 1.5 times higher for renal transplant (95% CI: 0.8, 2.8), 1.1 times for heart transplant (95% CI: 0.57, 2.1), 2.4 times for lung transplant (95% CI: 1.0, 5.8) and 7.9 times for multiple organ transplant (95% CI: 3.1, 20.1) as compared to liver transplant recipients.

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Conclusions: The incidence of post-transplant hyperglycemia and NODAT is 15.9% and 2.6% respectively, the risk being highest among multiple organ and least in liver transplant patients.

DISCLOSURES:Kim, S.: Grant/Research Support, Astellas Pharma Canada, Novartis Pharma Canada, Genzyme.

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