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Abstract: FR-PO827

Post-Simultaneous Kidney and Pancreas Transplant Outcomes in Type 2 Diabetics Compared to Type 1 Diabetics

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Liriano-Ward, Luz E., Montefiore Medical Center, Bronx, New York, United States
  • Al Azzi, Yorg, Montefiore Medical Center, Bronx, New York, United States
  • Kapoor, Sanjana, Montefiore Medical Center, Bronx, New York, United States
  • Ajaimy, Maria, Montefiore Medical Center, Bronx, New York, United States
  • Pynadath, Cindy T., Montefiore Medical Center, Bronx, New York, United States
  • Akalin, Enver, Montefiore Medical Center, Bronx, New York, United States
Background

The aim is to evaluate and compare short term and long-term outcomes in simultaneous kidney and pancreas transplant (SPK) recipients with a history of type 2 diabetes compared to those with type 1 diabetes

Methods

This is a retrospective review of all kidney and pancreas transplant recipients over 18 years of age transplanted at our center from June 2014 to December 2021

Results

107 SPK were performed at our center during the study period. 46.7% were type 2 diabetics and 53.3% were type 1. 80% were black or Hispanics (80%), but there was no racial difference between the two groups. The type 2 diabetics were older (median 49.5 (IQR 43-53.8) vs 35 (IQR 33-44), p<0.001), had lower pre-transplant HbA1c (7.6 ± 1.6 vs 8.4 ± 1.6 p= 0.04), and had higher c-peptide (5.1±2.6 vs 1.1± 2.4, p<0.001). There was no difference in BMI (25.6 ±3.9 in type 1 vs 27 ± 3.7 in type 2, p=0.096), pre-transplant insulin requirements, history of HTN, HLD, ESRD, and dialysis vintage. Type 1 diabetics developed more acute rejection (22.8% vs 2%, p 0.002) and CMV viremia (31.4% vs 10%, p 0.01). There was no difference in length of hospital stay, 30 days re-admissions, incidence of DGF in both kidney and pancreas allografts, hypoglycemia (BS<55), and need for oral antiglycemic drugs post-transplant. Mean serum creatinine levels were similar at 3 months (1.2 ± 0.45mg/dl vs 1.0 +/- 0.31mg/dl), p=1.6), and 6 months (1.3± 0.4mg dl vs 1.1 ± 0.33mg/dl, p=0.1). Type 2 diabetics had better kidney function at 1 year with mean eGFR 71 ± 27.3 vs 61 ± 22.7, p=0.06), but there was no difference in renal function at last follow up. There was no difference HbA1c levels at 6 months (median 5.2 (IQR 5-5.6) in type 1 vs 5.2 (IQR 5-5.6) in type 2, p=0.97) and 1 year (5.4 (IQR 5.3-5.7) vs 5.7 (IQR 5.2-5.7), p=0.3). During a median follow-up of 22 months (IQR 16-34.5), patient’s survival was 98% and kidney and pancreas graft survival was, 100% and 92%, respectively in type 2 diabetics. Meanwhile, patients’ survival was 88% and kidney and pancreas graft survival was 90% for both at a median follow up of 42months (17.5-60.5)

Conclusion

Type 1 diabetics were more likely to develop acute rejection and CMV viremia as compared to type 2 diabetics. Both patient’s and allografts’ survival are comparable between the two groups