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:|
| Hepatology |
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. John, of the Johns 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."