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Diabetes associated with morbidity, mortality after liver transplantation
In adults who undergo liver transplantation, the risks for mortality, graft rejection and adverse cardiovascular events are higher among those with diabetes compared with those without diabetes, study data show.
Juan Francisco Merino-Torres, PhD, of the endocrinology and nutrition department, Hospital Universitario y Politécnico La Fe in Valencia, Spain, and colleagues evaluated 178 adults who underwent liver transplantation during 2005 and 2006 to determine the effect of diabetes on morbidity and mortality. Data on morbidity and mortality were collected until 2016.
Overall, 35.4% of participants had diabetes.
Through follow-up, death occurred more often in the group with diabetes (41.3%) compared with the group without diabetes (27.8%).
The group with diabetes had a higher graft rejection rate (44.4%) compared with the group without diabetes (13%), revealing an increased risk for graft rejection in the diabetes group compared with the group without diabetes (OR = 4.9; 95% CI, 2.18-11.58). Reduced graft survival time was associated with diabetes (P = .001).
Compared with the group without diabetes, the group with diabetes had more episodes of acute myocardial infarction (6.3% vs. 0), a higher percentage of stroke (9.5% vs. 1.7%) and a higher percentage of peripheral arterial ischemia (7.9% vs. 2.6%). Overall, 19% of the diabetes group experienced a CV event compared with 3.5% of the group without diabetes, revealing an increased risk for CV events in the diabetes group (OR = 5.87; 95% CI, 1.81-23.2).
“We have found a significant relationship between [diabetes] and risk of liver graft rejection, and also a significant relationship with risk of [CV] events,” the researchers wrote. “A tendency to lower survival in patients with diabetes was observed, which was, however, not confirmed in the Cox regression model.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.