Outcome is poorer for diabetic patients following liver transplantation

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Outcome is poorer for diabetic patients following

liver transplantation

Morbidity and mortality after orthotopic liver

transplantation are greater in patients with

pre-existing diabetes, claims a team from Baltimore,

land, USA.

The researchers investigated the influence of

pre-existing diabetes mellitus on the outcome after

orthotopic liver transplantation (OLT).

They reported their findings in the November issue of

Hepatology.

The morbidity and mortality after OLT, in 57 patients

with pre-existing diabetes mellitus (3 type I, 54 type

II), were compared with 114 patients without the

disease.

Pre-transplantation serum creatinine was significantly

higher in the diabetic group compared with case

controls.

The incidence of a number of complications was found

to be significantly higher in the diabetic group after

OLT.

These included cardiovascular (61% vs 22%), renal (60%

vs 20%), ophthalmologic (11% vs 1%), and respiratory

complications (25% vs 7%).

5-year patient survival:

Diabetics: 34%

Controls: 68%

The occurrences of major (54% vs 30%) and minor

infections (30% vs 8%), and of malignancy (23% vs

11%), were also higher in the diabetic group.

Furthermore, neurologic (32% vs 7%), hematologic (19%

vs 3%), and musculoskeletal complications (25% vs 5%)

were heightened among the diabetics.

The duration of hospital stay, cost of

hospitalization, retransplantation, and overall graft

survival were similar between the groups.

Acute rejection was seen in 51% of diabetics, compared

with 25% in controls.

The researchers found that 1-year (87% vs 77%) and

2-year (82% vs 70%) patient survival was similar.

However, 5-year survival was lower in the diabetic

group (34% vs 68%).

Preeti R. , of the s Hopkins University School

of Medicine, Baltimore, concluded on behalf of fellow

authors, " Pre-existing diabetes is associated with a

significant post-OLT morbidity and mortality.

" Our observations suggest that patients with diabetes

mellitus warrant more rigorous pre- and post-OLT

evaluation. "

Hepatology 2001; 34: 889-95

31 October 2001

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