Organ transplant recipients who develop or have diabetes are more likely to die than those without diabetes, according to a comprehensive analysis of solid organ transplant recipients to be presented Saturday at the Endocrine Society’s annual meeting ENDO 2026 in Chicago, Illinois.
Diabetes is a common chronic disease that affects approximately 830 million people worldwide. Organ transplant recipients are at increased risk of developing and worsening diabetes, which can impact both lifespan and transplant success.
We studied how diabetes affects a person’s lifespan after solid organ transplantation and found that both ongoing diabetes and new-onset diabetes increase the risk of death. Until now, the magnitude of the impact of diabetes on survival had not been directly compared across major organ transplants. This study helps quantify the impact of diabetes across organ transplant types. ”
Mishal Ali research leader, University of Chicago, Chicago, Illinois.
Researchers looked at more than 800,000 Americans who received a kidney, liver, heart, lung, pancreas, or intestine transplant between 2003 and 2021. They compared two groups: people who already had diabetes when they received the new organ and people who developed diabetes for the first time after surgery.
They found that both groups were more likely to die than recipients without diabetes. For people receiving a new liver or heart, developing new diabetes was just as dangerous as having diabetes for many years. For people getting a new kidney, it’s still dangerous, but somewhat less dangerous than if they had diabetes to begin with. The association between diabetes diagnosis and type of organ failure varies by almost seven times depending on organ type.
In the group of recipients who already had diabetes, kidney recipients had the highest risk ever. Heart and liver recipients had a smaller increased risk compared to kidney. Lung recipients had the smallest increased risk. At 1 year, the differences were small, with about 1 to 2 additional deaths per 100 patients for kidney, liver, and heart, but little difference for lung recipients. This has changed over time. Ten years after transplantation, nearly 24 out of 100 diabetic kidney recipients died.
Among recipients who developed diabetes after surgery, kidney and heart recipients had the highest risk of death. Liver recipients had a slightly smaller increased risk, and lung recipients had the smallest increased risk.
“Transplant providers need to closely monitor current and new-onset diabetes. Because diabetes affects recipients differently depending on organ type, prevention and management must be individualized,” said senior author Alan L. Hutchison, M.D., a transplant liver specialist at the University of Chicago Medicine in Chicago, Illinois. “Patients and their families can ask transplant providers more specific questions about their risk for diabetes, both before surgery and in the months after surgery, and decide together whether to undergo additional testing or treatment.” ”
