Pre-transplant type 2 diabetes mellitus is associated with higher graft failure and increased 5-year mortality after heart transplantation

• Verfasst von: Rivinius, Rasmus [VerfasserIn]
• Verfasst von: Gralla, Carolin [VerfasserIn]
• Verfasst von: Helmschrott, Matthias [VerfasserIn]
• Verfasst von: Darche, Fabrice Fernand [VerfasserIn]
• Verfasst von: Ehlermann, Philipp [VerfasserIn]
• Verfasst von: Bruckner, Thomas [VerfasserIn]
• Verfasst von: Sommer, Wiebke [VerfasserIn]
• Verfasst von: Warnecke, Gregor [VerfasserIn]
• Verfasst von: Kopf, Stefan [VerfasserIn]
• Verfasst von: Szendrödi, Julia [VerfasserIn]
• Verfasst von: Frey, Norbert [VerfasserIn]
• Verfasst von: Kihm, Lars Philipp [VerfasserIn]
• Titel: Pre-transplant type 2 diabetes mellitus is associated with higher graft failure and increased 5-year mortality after heart transplantation
• Verf.angabe: Rasmus Rivinius, Carolin Gralla, Matthias Helmschrott, Fabrice F. Darche, Philipp Ehlermann, Tom Bruckner, Wiebke Sommer, Gregor Warnecke, Stefan Kopf, Julia Szendroedi, Norbert Frey and Lars P. Kihm
• E-Jahr: 2022
• Jahr: 09 June 2022
• Umfang: 12 S.
• Fussnoten: Gesehen am 29.07.2022
• Titel Quelle: Enthalten in: Frontiers in Cardiovascular Medicine
• Ort Quelle: Lausanne : Frontiers Media, 2014
• Jahr Quelle: 2022
• Band/Heft Quelle: 9(2022), Artikel-ID 890359, Seite 1-12
• ISSN Quelle: 2297-055X
• DOI: doi:10.3389/fcvm.2022.890359
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1811959792
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

AimsCardiac transplant recipients often suffer from type 2 diabetes mellitus (T2DM) but its influence on graft failure and post-transplant mortality remains unknown. The aim of this study was to investigate the long-term effects of pre-transplant T2DM in patients after heart transplantation (HTX).MethodsThis study included a total of 376 adult patients who received HTX at Heidelberg Heart Center between 01/01/2000 and 01/10/2016. HTX recipients were stratified by diagnosis of T2DM at the time of HTX. Patients with T2DM were further subdivided by hemoglobin A1c (HbA1c ≥ 7.0%). Analysis included donor and recipient data, immunosuppressive drugs, concomitant medications, post-transplant mortality, and causes of death. Five-year post-transplant mortality was further assessed by multivariate analysis (Cox regression) and Kaplan-Meier estimator.ResultsAbout one-third of all HTX recipients had T2DM (121 of 376 [32.2%]). Patients with T2DM showed an increased 5-year post-transplant mortality (41.3% versus 29.8%; P = 0.027) and had a higher percentage of death due to graft failure (14.9% versus 7.8%; P = 0.035). Multivariate analysis showed T2DM (HR: 1.563; 95% CI: 1.053-2.319; P = 0.027) as an independent risk factor for 5-year mortality after HTX. Kaplan-Meier analysis showed a significantly better 5-year post-transplant survival of patients with T2DM and a HbA1c < 7.0% than patients with T2DM and a HbA1c ≥ 7.0% (68.7% versus 46.3%; P = 0.008) emphasizing the clinical relevance of a well-controlled T2DM in HTX recipients.ConclusionPre-transplant T2DM is associated with higher graft failure and increased 5-year mortality after HTX.