Diabetes mellitus in living pancreas donors: Use of integrated national registry and pharmacy claims data to characterize donation-related health outcomes

Ngan N. Lam, Mark A. Schnitzler, Dorry L. Segev, Gregory P. Hess, Bertram L. Kasiske, Henry B. Randall, David Axelrod, Huiling Xiao, Amit X. Garg, Daniel C. Brennan, Krista L. Lentine

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background. Living donor pancreas transplant is a potential treatment for diabetic patients with end-organ complications. Although early surgical risks of donation have been reported, long-term medical outcomes in living pancreas donors are not known. Methods. We integrated national Scientific Registry of Transplant Recipients data (1987-2015) with records from a nationwide pharmacy claims warehouse (2005-2015) to examine prescriptions for diabetes medications and supplies as a measure of postdonation diabetes mellitus. To compare outcomes in controls with baseline good health, we matched living pancreas donors to living kidney donors (1:3) by demographic traits and year of donation. Results. Among 73 pancreas donors in the study period, 45 were identified in the pharmacy database: 62%women, 84%white, and 80%relatives of the recipient. Over a mean postdonation follow-up period of 16.3 years, 26.7% of pancreas donors filled prescriptions for diabetes treatments, compared with 5.9% of kidney donors (odds ratio, 4.13; 95% confidence interval, 1.91-8.93; P = 0.0003). Use of insulin (11.1% vs 0%) and oral agents (20.0% vs 5.9%; odds ratio, 4.50, 95% confidence interval, 2.09-9.68; P = 0.0001) was also higher in pancreas donors. Conclusions. Diabetes is more common after living pancreas donation than after living kidney donation, supporting clinical consequences from reduced endocrine reserve.

Original languageEnglish (US)
Pages (from-to)1276-1281
Number of pages6
JournalTransplantation
Volume101
Issue number6
DOIs
StatePublished - Jun 2017

Bibliographical note

Funding Information:
This work was supported by a grant from the National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NNL was supported by a KRESCENT New Investigator Award. AXG received an investigator-initiated grant from Astellas and Roche to support a CIHR-funded prospective study on living kidney donation, and his institution receives unrestricted funding from Pfizer. He is also supported by a Dr. Adam Linton Chair in Kidney Analytics.

Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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