Impact of preexisting diabetes mellitus on outcome after liver transplantation in patients with hepatitis B virus-related liver disease.
BACKGROUND
Preexisting diabetes mellitus (DM) has been reported to have an adverse consequence on patient prognosis after liver transplantation in the West. So far, there are few reports on the effect of preexisting DM on outcome of liver transplant recipients with HBV infection.


OBJECTIVE
We aimed to examine the impact of preexisting DM on post-transplant outcome in Chinese patients with HBV-related liver disease.


METHODS
The post-transplant morbidities and patient survival were compared between 48 diabetes patients (DM group) and 96 non-diabetes patients (control group) matched for age, gender, primary disease and model for end-stage liver diseases score. The DM group was further divided into hyperglycemia patients (fasting blood glucose >8.0 mmol/L, n = 22) and non-hyperglycemia patients (fasting blood glucose ≤8.0 mmol/L, n = 26).


RESULTS
Patient characteristics were comparable between both groups, except a higher incidence of hepatic encephalopathy in the DM group than that in the control group (22.9% vs. 10.4%, P = 0.045). The incidences of post-transplant complications and patient survival did not differ significantly between the DM and control groups, or between non-hyperglycemia patients and their matched case controls. Hyperglycemia patients showed a higher incidence of post-transplant sepsis (18.2% vs. 2.3%, P = 0.039) and biliary complications (31.8% vs. 6.8%, P = 0.012) than their matched case controls.


CONCLUSIONS
Preexisting DM is not a contraindication for liver transplantation in patients with HBV-related liver disease. A tight control of blood glucose to a level of ≤8.0 mmol/L was necessary to reduce the risk of complications after liver transplantation.
Ling
Qi
Q
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 79 QingChun Road, HangZhou, China.
Xu
Xiao
X
Wei
Qiang
Q
Wei
Xuyong
X
Wang
Zhuoyi
Z
Zhou
Lin
L
Zheng
Shusen
S
D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D001786:Blood Glucose / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D000075202:Contraindications; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D006501:Hepatic Encephalopathy / Q000453:epidemiology; D006509:Hepatitis B / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol; D003404:Creatinine