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Kidney Week

Abstract: FR-OR70

Pretransplant HbA1C as a Predictor of Kidney and Pancreas Allograft Survival in Simultaneous Pancreas-Kidney Transplantation: A Retrospective Nationwide Study

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Kittrakulrat, Jathurong, Prapokklao Hospital, Chanthaburi, Chanthaburi, Thailand
  • Tantisattamo, Ekamol, University of California Irvine, Irvine, California, United States
Background

Simultaneous pancreas-kidney transplant (SPKT) is a therapeutic option for patients with end-stage kidney disease (ESKD) and diabetes mellitus (DM). Hemoglobin A1C (HbA1C) is a widely used biomarker for glycemic control in DM patients. However, its role in predicting SPKT outcomes remains unclear. This study aimed to investigate the association of pre-transplant HbA1C levels with kidney and pancreas allograft survival in patients with SPKT.

Methods

Using data from the United Network for Organ Sharing (UNOS) database, a total of 3,351 SPKT recipients were included in the analysis. Cox proportional hazards regression models with time varying covariates were used to evaluate the association between HbA1C and allograft survival.

Results

Our results showed that higher pre-transplant HbA1C levels were significantly associated with lower kidney and pancreas allograft survival rates. Compared to patients with HbA1C levels ≤7%, patients with HbA1C levels >7% had a hazard ratio of 3.38 (95%CI: 2.40-4.75, P< 0.01) and 7.99 (95%CI: 6.02-10.60, P< 0.01) for kidney and pancreas allograft failure, respectively (Figure 1A and 1B). Moreover, this association remained significant after adjusting for relevant potential confounders, including age, gender, body mass index, and donor types.

Conclusion

Pre-transplant HbA1C is a strong predictor of both kidney and pancreas allograft outcomes in SPKT recipients. Our findings highlight the importance of glycemic control in uremic diabetic patients as one of the pre-transplant preparation strategies to improve allograft survival after successful SPKT.

Figure 1 : Graft Survival