MON-567 Diabetes After Heart Transplantation Is an Increasingly Common Issue

Abstract Disclosure: L.M. Raven: None. A. Jabbour: None. P.S. Macdonald: None. C.A. Muir: None. J.R. Greenfield: None. Background: Heart transplantation (HTx) survival rates have improved over the last 20 years with advances in immunosuppression and surgical techniques. Current five year survival rates approximate 85-90%. With these improvements there has been a greater focus on post-transplant care. Diabetes is common after transplantation and may be pre-existing (type 2 diabetes mellitus, T2DM) or develop after transplant (post-transplant diabetes mellitus, PTDM). In 2015 our institution introduced a dedicated endocrine clinic and registrar integrated into the heart and lung transplant unit. Aim: The aim of this study was to compare the incidence and prevalence of diabetes in HTx recipients in two cohorts separated by 20 years. Methods: Retrospective audit comparing the prevalence of T2DM and cumulative 2-year incidence of PTDM in consecutive HTx recipients in 1998 and 2018 at the same tertiary referral teaching hospital. People with type 1 diabetes mellitus were excluded from this analysis.Routine HTx immunosuppression differed between the two cohorts. In the 1998 cohort, maintenance immunosuppression consisted of cyclosporin, azathioprine and corticosteroids. Whereas the 2018 cohort were routinely treated with tacrolimus, mycophenolate and weaning corticosteroids. Results: There were 88 patients in the 1998 cohort and 141 in the 2018 cohort. The prevalence of T2DM at the time of HTx increased from 6% (n=5) in 1998 to 18% (n=25) in 2018, p=0.009. Similarly the incidence of PTDM increased from 15% (n=13) in 1998 to 30% (n=42) in 2018, p=0.01). HTx recipients who developed PTDM were older in 2018 (mean age 52 ± 11 years) vs 1998 (mean age 44 ± 9 years) (p=0.03). The groups without diabetes and with T2DM were similar in age between the two cohorts. Body mass index in the subgroups was not different between the cohorts. Conclusion: The incidence and prevalence of diabetes after HTx at our institution has increased over 20 years. With increasing HTx survival and rates of diabetes, endocrinologists should be incorporated into the care teams of transplant recipients. Further studies of diabetes therapies in this increasing cohort of patients with diabetes after transplantation is warranted. Presentation: Monday, July 14, 2025