Association of early post-transplant hyperglycaemia and diabetes mellitus on outcomes following heart transplantation.

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Diabetic Medicine Pub Date : 2024-09-25 DOI:10.1111/dme.15441

Christopher A Muir, William Kuang, Kavitha Muthiah, Jerry R Greenfield, Lisa M Raven

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Abstract

Aims: Early post-transplant hyperglycaemia (EPTH) and post-transplant diabetes mellitus (PTDM) are common following solid organ transplantation and may be associated with adverse outcomes. We studied the prevalence of EPTH and cumulative 5-year prevalence of PTDM in a modern cohort of heart transplant recipients who were free from diabetes at baseline as well as the association of EPTH, PTDM and pre-transplant T2DM with adverse transplant-related outcomes.

Methods: Retrospective cohort study of heart transplant recipients followed for 5 years at a single centre in Sydney, Australia.

Results: A total of 141 patients were included, of whom 25 had pre-existing type 2 diabetes mellitus (T2DM) and 116 were free from diabetes at baseline. In patients without pre-existing T2DM, 88 of 116 (76%) experienced EPTH, which was associated with higher rates of acute rejection and hospitalizations, and lower 5-year survival. PTDM developed in 45 of 116 (39%) patients, all of whom had experienced EPTH. Both PTDM and pre-existing T2DM were associated with increased rates of graft rejection and hospitalization, and greater than three-fold increased likelihood of death compared to patients that remained free from diabetes.

Conclusion: EPTH and PTDM are highly prevalent following cardiac transplantation. EPTH develops within days of transplant and is strongly associated with progression to PTDM. Pre-existing T2DM, PTDM and EPTH are associated with greater hospitalization, increased episodes of rejection and worse 5-year survival compared to patients who remained free from diabetes during follow-up.

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移植术后早期高血糖和糖尿病与心脏移植术后预后的关系。

目的：移植后早期高血糖（EPTH）和移植后糖尿病（PTDM）是实体器官移植后的常见病，可能与不良预后有关。我们研究了基线无糖尿病的现代心脏移植受者队列中 EPTH 的患病率和 PTDM 的 5 年累积患病率，以及 EPTH、PTDM 和移植前 T2DM 与移植相关不良预后的关系：方法：在澳大利亚悉尼的一个中心对心脏移植受者进行为期5年的回顾性队列研究：结果：共纳入 141 名患者，其中 25 人在移植前已患有 2 型糖尿病 (T2DM)，116 人在基线时没有糖尿病。在没有T2DM的患者中，116人中有88人（76%）发生了EPTH，这与较高的急性排斥反应率和住院率以及较低的5年存活率有关。116名患者中有45名（39%）发生了PTDM，他们都曾经历过EPTH。与没有糖尿病的患者相比，PTDM和原有的T2DM都与移植物排斥反应和住院率增加以及死亡可能性增加三倍以上有关：结论：心脏移植术后EPTH和PTDM的发病率很高。结论：EPTH 和 PTDM 在心脏移植术后发病率很高。与随访期间未患糖尿病的患者相比，既往患有T2DM、PTDM和EPTH的患者住院率更高，排斥反应发生率更高，5年生存率更低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”