title: The clinical course and outcomes of post-transplantation diabetes mellitus after heart transplantation.
abstract: The aim of this study was to describe in more detail the predisposition, natural course, and clinical impact of post-transplantation diabetes mellitus (PTDM) after heart transplantation (HT). The characteristics and clinical outcomes of 54 patients with PTDM were compared with those of 140 patients without PTDM. The mean age of PTDM patients was significantly higher than controls (48.9 ± 9.3 vs 38.6 ± 13.3 yr, respectively, P = 0.001), and ischemic heart disease was a more common indication of HT (20.4% [11/54] vs 7.1% [10/140], respectively, P = 0.008). In multivariate analysis, only recipient age (odds ratio, 1.80; 95% confidence interval, 1.35-2.40; P = 0.001) was associated with PTDM development. In 18 patients (33%), PTDM was reversed during the follow-up period, and the reversal of PTDM was critically dependent on the time taken to develop PTDM (1.9 ± 1.0 months in the reversed group vs 14.5 ± 25.3 months in the maintained group, P = 0.005). The 5-yr incidence of late infection (after 6 months) was higher in the PTDM group than in the control group (30.4% ± 7.1% vs 15.4% ± 3.3%, respectively, P = 0.031). However, the 5-yr overall survival rate was not different (92.9% ± 4.1% vs 85.8% ± 3.2%, respectively, P = 0.220). In conclusion, PTDM after HT is reversible in one-third of patients and is not a critical factor in patient survival after HT.
authors.affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Min Soo
authors.initials: MS
authors.lastname: Cho
authors.forename: Hyo-In
authors.initials: HI
authors.lastname: Choi
authors.forename: In-Ok
authors.initials: IO
authors.lastname: Kim
authors.forename: Sung-Ho
authors.initials: SH
authors.lastname: Jung
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Yun
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Min-Seok
authors.initials: MS
authors.lastname: Kim
authors.forename: Jae-Joong
authors.initials: JJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin