Transplant ( NODAT ) Risk Factors For Overcome...

Abstract New onset diabetes after transplant (NODAT) is an important complication after transplantation that increases risk for poor patient and graft outcomes. Recent studies in children identified older age, extremes of body mass index (BMI), and corticosteroid use at discharge as risk factors for NODAT. However, these studies were conducted in a national sample which underrated certain patient groups like deceased donor transplants and African American recipients. The purpose of this study was to determine the association between acute rejection (a surrogate for increased corticosteroid exposure) and NODAT in a pediatric kidney transplant program. A retrospective chart review was performed on a cohort of 121 consecutive pediatric kidney†¦show more content†¦The main risk factors include age ≠¥50 years old, male gender, family history of diabetes, and high systolic pulmonary artery pressure (PAP) 50mmHg.1,2 A review of data from the United States Renal Data System for primary renal transplant recipients ≠¤21 years old transplanted between 1995 and 2004 found the following risk factors for NODAT: African American children, BMI ≠¥ 30, increased age of child at time of transplant (≠¥13 years old), discharged on tacrolimus, and cytomegalovirus donor positive/recipient negative status.2 Cytomegalovirus (CMV) is herpes virus that is present in over sixty percent of adults that generally only causes non-specific fever and flu-like symptoms in immunocompetent hosts. In immunosuppressed transplant patients however, the virus can develop into a systemic infection involving several organ systems and increase the risk for transplant rejection.3 Other studies in children also identified corticosteroid use at discharge as a risk factors for NODAT.4 There have been no studies exploring the risk factors for NODAT in a population similar to that at Children’s of Alabama, which is distinct due to a large number of deceased donor transplants and African-American recipients with higher immunologic risk. The purpose of this study was to determine the association between acute rejection (a surrogate for increased corticosteroid exposure) and NODAT in this kidney transplant program. Methods Before initiation of this research, a literature