RT Journal Article
SR Electronic
A1 Bedanova, Helena
A1 Ondrasek, Jiri
A1 Cerny, Jan
A1 Orban, Marek
A1 Spinarova, Lenka
A1 Hude, Petr
A1 Krejci, Jan
A1 Nemec, Petr
T1 IMPACT OF DIABETES MELLITUS ON SURVIVAL RATES AFTER HEART TRANSPLANTATION
JF Biomedical papers
YR 2009
VO 153
IS 4
SP 283
OP 287
DO 10.5507/bp.2009.047
UL https://biomed.papers.upol.cz/artkey/bio-200904-0009.php
AB Aims: Heart transplantation (HTx) is the most effective therapy in patients with end-stage heart failure. Diabetesrelated complications are relative contraindications for heart transplantation. The aim of our study was to analyse the impact of DM (diabetes mellitus) at the time of heart transplantation and new-onset post-transplantation DM on long-term survival.
Methods: A retrospective database analysis was performed on all patients who had undergone HTx at our institution between 4/1997 and 9/2007. Patients were divided into three groups: Group A - patients without DM; Group B - patients with new onset of DM after HTx; Group C - patients with DM prior to HTx.
Results: Patients with DM before the surgery were more obese, their BMI was 27.7 ± 2.90, compared to groups A and B with BMI of 24.7 ± 3.37 and 25.3 ± 3.64 respectively (p = 0.0003). Patients in group B had statistically significantly higher risk of developing acute rejection (G 1B and more according to International Society of Heart and Lung Transplantation - ISHLT - classification) (p = 0.0350). The incidence of infections between individual groups showed no statistically significant differences (p = 0.5839). Five-year survival in group A was 82%, 10-year survival was 73%. Corresponding numbers for group B were 86% and 78%, for group C 86% and 83%. Differences between groups were not statistically significant (p = 0.2560).
Conclusions: DM in patients after heart transplantation in our study had no effect on long-term survival of patients. Post-transplantation DM increases risk of acute rejections. Pre-transplantation DM was associated with excessive bodyweight or obesity.