Morbidity and mortality in diabetic patients following cardiac transplantation

Chim C. Lang, Ainat Beniaminovitz, Niloo Edwards, Donna M. Mancini

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    35 Citations (Scopus)

    Abstract

    Background:
    Diabetes remains a relative contraindication to cardiac transplantation. Previous reports have described small numbers of diabetic patients without end-organ damage who have undergone successful cardiac transplantation.
    Methods:
    A retrospective analysis of diabetic patients transplanted and their outcome in a single large center from 1/1/95 to 12/31/99 was performed. Diabetes was defined as “medium risk” by the presence of any of the following parameters: duration of therapy >10 years; use of insulin; serum creatinine >2 mg/dl; urinary protein >300 mg per 24 hours; presence of peripheral vascular disease (ankle:brachial ratio <1.0); and documentation of other diabetic comorbidity (retinopathy, neuropathy, gastroparesis).
    Results:
    During this time period, 374 adult cardiac transplants were performed. Seventy-six patients (20%) were diabetic with 33 patients (43%) requiring insulin. Forty-two of the patients had moderate disease. Survival of the diabetic and non-diabetic recipients was comparable (1- and 3-year survival of 86% and 85%. vs 87% and 84%, respectively, p = NS). No difference in survival between “medium-risk” and “low-risk” diabetics was observed. The incidence of acute rejection in the first year, graft vasculopathy and infection, was comparable between diabetic and non-diabetic patients. In both diabetic and non-diabetic patients, there was a similar and small insignificant increase in serum creatinine.
    Conclusions:
    More patients with advanced diabetes are undergoing cardiac transplantation and the early and mid-term survival remains comparable to non-diabetic recipients. Future liberalization of transplantation in diabetics appears likely.
    Original languageEnglish
    Pages (from-to)244-249
    Number of pages6
    JournalJournal of Heart and Lung Transplantation
    Volume22
    Issue number3
    DOIs
    Publication statusPublished - Mar 2003

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