BACKGROUND: Patients with diabetes mellitus overall experience worse health outcomes than non-diabetics, but whether this is true among recipients of liver transplantation still remains unclear. The aim of this study was to compare the mortality of diabetic and non-diabetic patients following liver transplantation. METHODS: We conducted a retrospective analysis of 530 adult patients undergoing liver transplantation at Stanford University Medical Center from February 1995 to July 2006. Information on diabetes mellitus was available for 431 patients; 96 patients who had acute liver failure (n = 17), combined liver and kidney transplantation (n = 28), or died prior to discharge (n = 51) were excluded from analysis. RESULTS: Over a mean follow-up of 4.5 years, survival was 81% in the diabetic group and 94% among controls (p = <0.0001). After controlling for age (mean +/- SD: 54.4 +/- 7.6 in diabetics, 50.1 +/- 9.6 in controls), body mass index (28.6 +/- 6.6 in diabetics, 27.1 +/- 5.4 in controls), presence of hepatitis C, and MELD score (17 +/- 9.6 in diabetics, 19 +/- 10.2 in controls), diabetes mellitus remained a significant predictor of death (HR 3.11, p = 0.01). CONCLUSIONS: Diabetes mellitus is an independent risk factor for mortality following liver transplantation. Further investigation of this relationship should focus on the impact of more intensive pre- and post-liver transplantation glucose control, cardiovascular risk factor reduction, and the effects of accelerated atherosclerosis in the setting of immune suppression.
BACKGROUND:Patients with diabetes mellitus overall experience worse health outcomes than non-diabetics, but whether this is true among recipients of liver transplantation still remains unclear. The aim of this study was to compare the mortality of diabetic and non-diabeticpatients following liver transplantation. METHODS: We conducted a retrospective analysis of 530 adult patients undergoing liver transplantation at Stanford University Medical Center from February 1995 to July 2006. Information on diabetes mellitus was available for 431 patients; 96 patients who had acute liver failure (n = 17), combined liver and kidney transplantation (n = 28), or died prior to discharge (n = 51) were excluded from analysis. RESULTS: Over a mean follow-up of 4.5 years, survival was 81% in the diabetic group and 94% among controls (p = <0.0001). After controlling for age (mean +/- SD: 54.4 +/- 7.6 in diabetics, 50.1 +/- 9.6 in controls), body mass index (28.6 +/- 6.6 in diabetics, 27.1 +/- 5.4 in controls), presence of hepatitis C, and MELD score (17 +/- 9.6 in diabetics, 19 +/- 10.2 in controls), diabetes mellitus remained a significant predictor of death (HR 3.11, p = 0.01). CONCLUSIONS:Diabetes mellitus is an independent risk factor for mortality following liver transplantation. Further investigation of this relationship should focus on the impact of more intensive pre- and post-liver transplantation glucose control, cardiovascular risk factor reduction, and the effects of accelerated atherosclerosis in the setting of immune suppression.
Authors: R Kashyap; A Jain; J Reyes; A J Demetris; K A Elmagd; S F Dodson; W Marsh; V Madariaga; G Mazariegos; D Geller; C A Bonham; T Cacciarelli; P Fontes; T E Starzl; J J Fung Journal: Transplant Proc Date: 2001 Feb-Mar Impact factor: 1.066
Authors: K V Narayanan Menon; Scott L Nyberg; William S Harmsen; Nelson F DeSouza; Charles B Rosen; Ruud A F Krom; Russell H Wiesner Journal: Am J Transplant Date: 2004-05 Impact factor: 8.086
Authors: A Ramos-Prol; D Hervás-Marín; B Rodríguez-Medina; M Rubio-Almanza; M Berenguer; Á Moya-Herraiz; J F Merino-Torres Journal: J Endocrinol Invest Date: 2017-12-30 Impact factor: 4.256
Authors: Abby B Siegel; Emerson A Lim; Shuang Wang; William Brubaker; Rosa D Rodriguez; Abhishek Goyal; Judith S Jacobson; Dawn L Hershman; Elizabeth C Verna; Jonah Zaretsky; Karim Halazun; Lorna Dove; Robert S Brown; Alfred I Neugut; Tomoaki Kato; Helen Remotti; Yael J Coppleson; Jean C Emond Journal: Transplantation Date: 2012-09-15 Impact factor: 4.939
Authors: S Yue; H M Zhou; J J Zhu; J H Rao; R W Busuttil; J W Kupiec-Weglinski; L Lu; Y Zhai Journal: Am J Transplant Date: 2015-06-25 Impact factor: 9.369