Prior diabetes mellitus is associated with increased morbidity in cystic fibrosis patients undergoing bilateral lung transplantation: an 'orphan' area? A retrospective case-control study.
BACKGROUND
The aim of this study was to determine whether pre-existing diabetes mellitus increases the risk of rejection, infection and/or death in cystic fibrosis patients undergoing bilateral sequential single-lung transplantation.


METHODS
A retrospective audit of 25 consecutive patients with cystic fibrosis who underwent bilateral sequential single-lung transplantation between 1 January 2003 and 31 December 2005 at a tertiary referral hospital was carried out.


RESULTS
Although 32% patients had diabetes diagnosed before lung transplantation, 92% had random blood glucose levels > or =11.1 mmol/L requiring insulin during admission. Patients with pre-existing diabetes had increased infection-related (3.9 vs 1.2, P= 0.01) and putative rejection-related (1.4 vs 0.5, P= 0.04) hospital admissions post-transplantation compared with those without diabetes pre-transplant. During the period of observation, four of eight patients with a prior diagnosis of diabetes died compared with none of 17 patients without prior diabetes (P= 0.0055).


CONCLUSIONS
Almost all cystic fibrosis patients develop hyperglycaemia after lung transplantation, but patients with prior diabetes have more complication-related admissions to hospital and a higher mortality rate.
Bradbury
R A
RA
Department of Endocrinology, St Vincent's Hospital, Sydney, New South Wales, Australia.
Shirkhedkar
D
D
Glanville
A R
AR
Campbell
L V
LV
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003550:Cystic Fibrosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D055815:Young Adult