TY - JOUR
T1 - Additive impact of pre-liver transplant metabolic factors on survival post-liver transplant
AU - Adams, Leon
AU - Arauz, O.
AU - Angus, P.W.
AU - Sinclair, M.
AU - Macdonald, G.A.
AU - Chelvaratnam, U.
AU - Wigg, A.J.
AU - Yeap, S.
AU - Shackel, N.
AU - Lin, L.
AU - Raftopoulos, S.
AU - Mccaughan, G.W.
AU - Jeffrey, Gary
AU - Delriviere, L.
AU - Lynch, S.
AU - Jones, R.
AU - Munn, S.
AU - Padbury, R.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. Background and Aim:: Diabetes at time of liver transplantation is associated with reduced post-transplant survival. We aimed to assess whether additional metabolic conditions such as obesity or hypertension had additive prognostic impact on post-transplantation survival. Methods:: A multi-center cohort study of 617 adult subjects undergoing liver transplantation between 2003 and 2009 has been used. Dry body mass index was calculated following adjustment for ascites. Results:: After a median follow-up of 5.8years (range 0-10.5), 112 (18.2%) patients died. Diabetes was associated with reduced post-transplant survival (hazard ratio 1.89, 95% confidence interval [CI] 1.25-2.86, P=0.003), whereas obesity, hypertension, dyslipidemia, and the metabolic syndrome itself were not (P>0.3 for all). Patients with concomitant diabetes and obesity had lower survival (adjusted Hazard Ratio [aHR] 2.40, 95%CI 1.32-4.38, P=0.004), whereas obese non-diabetic patients or diabetic non-obese patients had similar survival compared with non-diabetic, non-obese individuals. The presence of hypertension or dyslipidemia did not impact on survival in patients with diabetes (P>0.1 for both). Obese diabetic patients had longer intensive care and hospital stays than non-obese diabetic or obese, non-diabetic patients (P
AB - © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. Background and Aim:: Diabetes at time of liver transplantation is associated with reduced post-transplant survival. We aimed to assess whether additional metabolic conditions such as obesity or hypertension had additive prognostic impact on post-transplantation survival. Methods:: A multi-center cohort study of 617 adult subjects undergoing liver transplantation between 2003 and 2009 has been used. Dry body mass index was calculated following adjustment for ascites. Results:: After a median follow-up of 5.8years (range 0-10.5), 112 (18.2%) patients died. Diabetes was associated with reduced post-transplant survival (hazard ratio 1.89, 95% confidence interval [CI] 1.25-2.86, P=0.003), whereas obesity, hypertension, dyslipidemia, and the metabolic syndrome itself were not (P>0.3 for all). Patients with concomitant diabetes and obesity had lower survival (adjusted Hazard Ratio [aHR] 2.40, 95%CI 1.32-4.38, P=0.004), whereas obese non-diabetic patients or diabetic non-obese patients had similar survival compared with non-diabetic, non-obese individuals. The presence of hypertension or dyslipidemia did not impact on survival in patients with diabetes (P>0.1 for both). Obese diabetic patients had longer intensive care and hospital stays than non-obese diabetic or obese, non-diabetic patients (P
U2 - 10.1111/jgh.13240
DO - 10.1111/jgh.13240
M3 - Article
C2 - 26589875
SN - 0815-9319
VL - 31
SP - 1016
EP - 1024
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 5
ER -
