Abstract 17362: New-onset Diabetes After Pediatric Heart Transplantation
Introduction: New-onset Diabetes after Transplantation (NDT) is a well defined complication after solid organ transplantation. Little has been published describing the incidence, risk factors, and effect on outcome after pediatric heart transplantation.
Hypothesis: Herein, we aim to describe the incidence and risk factors for the development of NDT.
Methods: We performed a retrospective cohort analysis of patients ≤ 18 years of age alive at 1 year post transplant from the Pediatric Heart Transplant Study event driven database from 2004 to 2014. Continuous variables were compared using Wilcoxon rank-sum and Chi squared analysis was were used for categorical variables. Kaplan-Meier method was used to assess survival and Log-rank method to compare curves. Logistic regression was used to identify independent risk factors.
Results: Of the 2163 recipients, 1767 were alive and followed at 1 year. The freedom from NDT was 98.32% (95CI 97.98% - 98.60%), 94.73% (95CI 94.04% - 95.35%), and 86.07% (95CI 83.21% - 88.52%) at 1, 5, and 10 years, respectively. Patients with NDT were more likely to be older at time of transplant (6.35 ± 6.04 vs. 12.32 ± 4.51, p<0.0001) with 60% over the age of 12, to be of non-white race (28.6% vs. 54.8%, p=0.0002), and to have an increased BMI at time of transplant (17.41 ± 4.60 vs. 21.65 ± 6.25, p<0.0001) with 32% having a BMI ≥ 25. On multivariable analysis, risk factors for NDT at one-year post transplant were black race [HR 2.36 (1.25 - 4.47), p=0.009], older age at transplant [HR 1.16 (1.09 - 1.24), p<0.0001], and BMI ≥ 25 at transplant [HR 2.5 (1.18 - 5.29, p=0.02].
Conclusion: Though uncommon, NDT occurs with a continuous hazard after pediatric heart transplant; more often in older patients at transplant, those who are of non-white race, and those with higher BMI (a potential modifiable risk factor). Therefore, targeted weight reduction in at risk populations could prevent NDT. Further data is needed to determine whether NDT alters the outcome after transplant.
Author Disclosures: J.D. Sparks: None. E.P. Pruitt: None. J.K. Kirklin: None. T. Brown: None. M.P. Carboni: None. W.J. Dreyer: None. S. Kindel: None. T.D. Ryan: None. R. Morrow: None.
- © 2016 by American Heart Association, Inc.