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Dig Dis Sci. 2010 Jul;55(7):2089-94. doi: 10.1007/s10620-010-1267-5. Epub 2010 May 14.

Diabetes mellitus increases the risk of mortality following liver transplantation independent of MELD score.

Author information

1
Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Stanford, CA 94305-5109, USA. andysam@stanford.edu

Abstract

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.

PMID:
20467898
DOI:
10.1007/s10620-010-1267-5
[Indexed for MEDLINE]

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