Additive impact of pre-liver transplant metabolic factors on survival post-liver transplant

Leon Adams, O. Arauz, P.W. Angus, M. Sinclair, G.A. Macdonald, U. Chelvaratnam, A.J. Wigg, S. Yeap, N. Shackel, L. Lin, S. Raftopoulos, G.W. Mccaughan, Gary Jeffrey, L. Delriviere, S. Lynch, R. Jones, S. Munn, R. Padbury

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    17 Citations (Scopus)

    Abstract

    © 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
    Original languageEnglish
    Pages (from-to)1016-1024
    JournalJournal of Gastroenterology and Hepatology (Australia)
    Volume31
    Issue number5
    DOIs
    Publication statusPublished - 2016

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