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

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).Me...

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Main Authors: Rivinius, Rasmus (Author) , Gralla, Carolin (Author) , Helmschrott, Matthias (Author) , Darche, Fabrice Fernand (Author) , Ehlermann, Philipp (Author) , Bruckner, Thomas (Author) , Sommer, Wiebke (Author) , Warnecke, Gregor (Author) , Kopf, Stefan (Author) , Szendrödi, Julia (Author) , Frey, Norbert (Author) , Kihm, Lars Philipp (Author)
Format: Article (Journal)
Language:English
Published: 09 June 2022
In: Frontiers in Cardiovascular Medicine
Year: 2022, Volume: 9, Pages: 1-12
ISSN:2297-055X
DOI:10.3389/fcvm.2022.890359
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fcvm.2022.890359
Verlag, kostenfrei, Volltext: https://www.frontiersin.org/articles/10.3389/fcvm.2022.890359
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Author Notes: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
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Summary: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.
Item Description:Gesehen am 29.07.2022
Physical Description:Online Resource
ISSN:2297-055X
DOI:10.3389/fcvm.2022.890359

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