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Impact of Preexisting Diabetes Mellitus on Outcome After Liver Transplantation in Patients with Hepatitis B Virus-Related Liver Disease

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Abstract

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.

Aims

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.

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Acknowledgments

This work was supported by the National Basic Research Program of China (973 Program) (No. 2009CB522403) and the National Key Technology R&D Program (No. 2008BAI60B03).

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Authors and Affiliations

  1. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, 79 QingChun Road, HangZhou, China

    Qi Ling, Xiao Xu, Qiang Wei, Xuyong Wei, Zhuoyi Wang, Lin Zhou & Shusen Zheng

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  1. Qi Ling
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  2. Xiao Xu
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  3. Qiang Wei
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  4. Xuyong Wei
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  5. Zhuoyi Wang
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  6. Lin Zhou
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  7. Shusen Zheng
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Corresponding author

Correspondence to Shusen Zheng.

Additional information

Qi Ling and Xiao Xu contributed equally to this work.

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Ling, Q., Xu, X., Wei, Q. et al. Impact of Preexisting Diabetes Mellitus on Outcome After Liver Transplantation in Patients with Hepatitis B Virus-Related Liver Disease. Dig Dis Sci 56, 889–893 (2011). https://doi.org/10.1007/s10620-010-1358-3

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  • DOI: https://doi.org/10.1007/s10620-010-1358-3

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