Outcomes in patients with diabetes 10 years after liver transplantation

Autores de IIS La Fe

• Agustin Ramos Prol

  Autor

• David Hervás Marín

  Autor

• Alia Maria Garcia Castells

  Autor

• Juan Francisco Merino Torres

  Autor

Grupos

• Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética clínica

  Leader

  Juan Francisco Merino Torres

Abstract

BackgroundThere are discrepancies between studies regarding the effect of diabetes mellitus on morbidity and mortality in patients undergoing liver transplantation. The aim of the present study was to compare mortality, risk of liver graft rejection, and cardiovascular events in patients with and without diabetes undergoing liver transplantation over a 10-year follow-up period. MethodsA retrospective study was performed on 183 patients who underwent liver transplantation in 2005 and 2006. Mortality and morbidity data were collected until 2016, including information on mortality and survival time, graft rejection and graft survival time, coronary heart disease, stroke, and peripheral arterial ischemia. ResultsDuring the follow-up, 41.3% and 27.8% of patients in the groups with and without diabetes, respectively, died. A trend for lower survival time was observed in patients with diabetes, although this effect was not confirmed by the Cox regression model. There was an increased risk of graft rejection in the group with diabetes compared with the group without diabetes (P< 0.001). In the survival analysis, diabetes was associated with reduced graft survival time (P=0.001). Cardiovascular events were also more likely in the group with diabetes (P=0.005). ConclusionsIn the present study diabetes was associated with a higher risk of liver graft rejection and cardiovascular events. There was also a trend for higher mortality, although the effect was not statistically significant. These findings suggest that patients with diabetes require a more rigorous pretransplant evaluation and closer monitoring after transplantation in order to try to reduce associated complications.

Keywords

• cardiovascular events; diabetes; graft rejection; liver transplantation