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Effect of Early Steroid Withdrawal on Posttransplant Diabetes Among Kidney Transplant Recipients Differs by Recipient Age
Ahn, JiYoon B; Bae, Sunjae; Schnitzler, Mark; Hess, Gregory P; Lentine, Krista L; Segev, Dorry L; McAdams-DeMarco, Mara A
Background/UNASSIGNED:Posttransplant diabetes (PTD), a major complication after kidney transplantation (KT), is often attributable to immunosuppression. The risk of PTD may increase with more potent steroid maintenance and older recipient age. Methods/UNASSIGNED:Using United States Renal Data System data, we studied 12 488 adult first-time KT recipients (2010-2015) with no known pre-KT diabetes. We compared the risk of PTD among recipients who underwent early steroid withdrawal (ESW) versus continued steroid maintenance (CSM) using Cox regression with inverse probability weighting to adjust for confounding. We tested whether the risk of PTD resulting from ESW differed by recipient age (18-29, 30-54, and ≥55 y). Results/UNASSIGNED:). Conclusions/UNASSIGNED:The beneficial association of ESW with decreased PTD was more pronounced among recipients aged ≥55, supporting an age-specific assessment of the risk-benefit balance regarding ESW.
PMCID:8670588
PMID: 34912947
ISSN: 2373-8731
CID: 5127802
Characterizing the early impact of the Kidney Accelerated Placement Project on hard-to-place kidneys [Meeting Abstract]
Motter, Jennifer; Kernodle, Amber; Gentry, Sommer; Levan, Macey; Wood, Nicholas; Segev, Dorry; Garonzik-Wang, Jacqueline; Massie, Allan
ISI:000739470700152
ISSN: 1600-6135
CID: 5133672
Does MELD-GRAIL-Na Correct Racial Disparities In Survival Without A Liver Transplant? [Meeting Abstract]
VanDerwerken, Doug; Wood, Nicholas; Segev, Dorry; Gentry, Sommer
ISI:000739470700067
ISSN: 1600-6135
CID: 5133582
Facilitating Education and Advocacy Training to Expand Live Donor Kidney Transplantation in the setting of the COVID-19 pandemic: Experience with the ENGAGE Multi-center Trial [Meeting Abstract]
Mitchell, Jonathan; Lopez, Julia; Nijhar, Kieranjeet; Zeiser, Laura Bowles; Chiang, Teresa; King, Elizabeth; Segev, Dorry; Cameron, Andrew
ISI:000739470700146
ISSN: 1600-6135
CID: 5133662
Long-term Frailty Trajectories After Kidney Transplantation [Meeting Abstract]
Ruck, Jessica; Chu, Nadia; Chen, Xiaomeng; Bandeen-Roche, Karen; Norman, Silas; Segev, Dorry; McAdams-DeMarco, Mara
ISI:000739470700169
ISSN: 1600-6135
CID: 5133682
CT measurements of body composition before liver transplant: How are they correlated with post-transplant outcomes? [Meeting Abstract]
Liu, Yi; Shafaat, Omid; Jackson, Kyle; Motter, Jennifer; Boyarsky, Brian; Latif, Muhammad; Yuan, Frank; King, Elizabeth; Zaheer, Atif; Summers, Ronald; Segev, Dorry; McAdams-DeMarco, Mara; Weiss, Clifford
ISI:000739470700090
ISSN: 1600-6135
CID: 5133592
Diabetes-free survival among living kidney donors and non-donors with obesity: A longitudinal cohort study
Killian, A Cozette; Reed, Rhiannon D; McLeod, M Chandler; MacLennan, Paul A; Kumar, Vineeta; Pittman, Sydney E; Maynor, Andrew G; Stanford, Luke A; Baker, Gavin A; Schinstock, Carrie A; Silkensen, John R; Roll, Garrett R; Segev, Dorry L; Orandi, Babak J; Lewis, Cora E; Locke, Jayme E
BACKGROUND:Approval of living kidney donors (LKD) with end-stage kidney disease (ESKD) risk factors, such as obesity, has increased. While lifetime ESKD development data are lacking, the study of intermediate outcomes such as diabetes is critical for LKD safety. Donation-attributable diabetes risk among persons with obesity remains unknown. The purpose of this study was to evaluate 10-year diabetes-free survival among LKDs and non-donors with obesity. METHODS:This longitudinal cohort study identified adult, LKDs (1976-2020) from 42 US transplant centers and non-donors from the Coronary Artery Risk Development in Young Adults (1985-1986) and the Atherosclerosis Risk in Communities (1987-1989) studies with body mass index ≥30 kg/m2. LKDs were matched to non-donors on baseline characteristics (age, sex, race, body mass index, systolic and diastolic blood pressure) plus diabetes-specific risk factors (family history of diabetes, impaired fasting glucose, smoking history). Accelerated failure time models were utilized to evaluate 10-year diabetes-free survival. FINDINGS:Among 3464 participants, 1119 (32%) were LKDs and 2345 (68%) were non-donors. After matching on baseline characteristics plus diabetes-specific risk factors, 4% (7/165) LKDs and 9% (15/165) non-donors developed diabetes (median follow-up time 8.5 (IQR: 5.6-10.0) and 9.1 (IQR: 5.9-10.0) years, respectively). While not significant, LKDs were estimated to live diabetes-free 2 times longer than non-donors (estimate 1.91; 95% CI: 0.79-4.64, p = 0.15). CONCLUSIONS:LKDs with obesity trended toward living longer diabetes-free than non-donors with obesity, suggesting within the decade following donation there was no increased diabetes risk among LKDs. Further work is needed to evaluate donation-attributable diabetes risk long-term.
PMCID:9674148
PMID: 36399462
ISSN: 1932-6203
CID: 5371742
Increased Logistical Complexity In Circle-Based Organ Allocation [Meeting Abstract]
Wood, Nicholas; VanDerwerken, Douglas; Segev, Dorry; Gentry, Sommer
ISI:000739470700198
ISSN: 1600-6135
CID: 5133692
Designing Continuous Distribution for Liver Allocation. [Meeting Abstract]
Mankowski, M.; Wood, N.; Segev, D.; Gentry, S.
ISI:000842606302312
ISSN: 1600-6135
CID: 5486642
Opportunities for Improved Efficiency in Kidney Distribution: A Comparison of Center-Specified UNet Donor Criteria to Actual Kidney Acceptance Practices [Meeting Abstract]
Zeiser, Laura; Gentry, Sommer; Segev, Dorry; Massie, Allan
ISI:000739470700207
ISSN: 1600-6135
CID: 5133702