Impact of Preexisting Diabetes Mellitus on Outcome After Liver Transplantation in Patients with Hepatitis B Virus-Related Liver Disease
Impact of Preexisting Diabetes Mellitus on Outcome After Liver Transplantation in Patients with Hepatitis B Virus-Related Liver Disease
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DOI：
10.1007/s10620-010-1358-3
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发表时间：
2011-03-01
影响因子：
3.1
通讯作者：
Zheng, Shusen
中科院分区：
文献类型：
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作者：
Ling, Qi;Xu, Xiao;Zheng, Shusen
西方有报道称，既往存在的糖尿病(DM)对肝移植后患者的预后有不良影响。以48例糖尿病患者(DM组)和96例非糖尿病患者(对照组)为研究对象，比较了48例糖尿病患者(DM组)和96例非糖尿病患者(对照组)的移植后发病率和患者存活率，并与年龄、性别、原发病和终末期肝病模型评分相匹配的非糖尿病患者(对照组)进行比较。糖尿病组又分为高血糖组(空腹血糖+GT8.0 mm o l/L，n=22)和非高血糖组(空腹血糖<千分之8.0 mm o l/L，n=26)。除DM组肝性脑病的发生率高于对照组(22.9%vs.10.4%，P=0.045)外，两组患者的临床特征基本相似。移植后并发症的发生率和患者存活率在糖尿病组和对照组之间、非高血糖患者和他们匹配的病例对照组之间没有显著差异。高血糖组移植后败血症发生率(18.2%比2.3%，P=0.039)和胆道并发症发生率(31.8%比6.8%，P=0.012)均高于对照组。为减少肝移植术后并发症的发生，有必要严格控制血糖至千分之八的水平(P<0.0 5)。
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.We aimed to examine the impact of preexisting DM on post-transplant outcome in Chinese patients with HBV-related liver disease.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 a parts per thousand currency sign8.0 mmol/L, n = 26).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.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 a parts per thousand currency sign8.0 mmol/L was necessary to reduce the risk of complications after liver transplantation.