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Type 2 diabetes and obesity influence liver transplant outcomes

September's Alimentary Pharmacology & Therapeutics evaluates the impact of type 2 diabetes and obesity on the long-term outcomes of liver transplant recipients in the USA.

News image

Type 2 diabetes is known to negatively impact the outcome of chronic liver disease.

Dr Younossi and colleagues from Virginia, USA evaluated the impact of diabetes on the outcomes of liver transplants.

Study cohort included adults who received liver transplants in the US between 1994 and 2013.

Pre- and post-transplant diabetes was recorded in patients with mortality follow-up.

The researchers included 85,194 liver transplant recipients.

Of those, 11% had history of pre-transplant diabetes.

8% of donors had history of diabetes
Alimentary Pharmacology & Therapeutics

The team found that the most common indications for liver transplant were hepatitis C, alcohol-related liver disease, primary liver malignancy of unspecified etiology, cryptogenic cirrhosis, hepatitis B, and non-alcoholic steatohepatitis.

The researchers observed that a total of 97% transplants were from deceased donors, and 8% of donors had history of diabetes.

During an average 7 years of follow-up, 31% of recipients died, and 9% had a graft failure.

The research team found that, after adjustment for age, ethnicity, insurance type, history of chronic diseases, HCV infection and noncompliance, independent predictors of recipient mortality included the presence of pre-transplant diabetes, and developing diabetes post-transplant.

The team noted that donor's history of diabetes was also independently associated with higher mortality.

Furthermore, donor's history of diabetes was also associated with an increased the risk of liver graft failure.

Dr Younossi's team concludes, "Presence of type 2 diabetes pre- and post-transplant, as well as presence of type 2 diabetes in the donors, are all associated with an increased risk of adverse post-transplant outcomes."

Aliment Pharmacol Ther 2014: 40(6): 686–694
05 September 2014

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