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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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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Transplants
Survival
Liver
Obesity
Gastroenterology
Dyslipidemias
Hypertension
Liver Transplantation
Confidence Intervals
Critical Care
Nuclear Family
Ascites
Length of Stay
Body Mass Index
Cohort Studies
Transplantation

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Adams, Leon ; Arauz, O. ; Angus, P.W. ; Sinclair, M. ; Macdonald, G.A. ; Chelvaratnam, U. ; Wigg, A.J. ; Yeap, S. ; Shackel, N. ; Lin, L. ; Raftopoulos, S. ; Mccaughan, G.W. ; Jeffrey, Gary ; Delriviere, L. ; Lynch, S. ; Jones, R. ; Munn, S. ; Padbury, R. / Additive impact of pre-liver transplant metabolic factors on survival post-liver transplant. In: Journal of Gastroenterology and Hepatology (Australia). 2016 ; Vol. 31, No. 5. pp. 1016-1024.
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abstract = "{\circledC} 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",
author = "Leon Adams and O. Arauz and P.W. Angus and M. Sinclair and G.A. Macdonald and U. Chelvaratnam and A.J. Wigg and S. Yeap and N. Shackel and L. Lin and S. Raftopoulos and G.W. Mccaughan and Gary Jeffrey and L. Delriviere and S. Lynch and R. Jones and S. Munn and R. Padbury",
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Adams, L, Arauz, O, Angus, PW, Sinclair, M, Macdonald, GA, Chelvaratnam, U, Wigg, AJ, Yeap, S, Shackel, N, Lin, L, Raftopoulos, S, Mccaughan, GW, Jeffrey, G, Delriviere, L, Lynch, S, Jones, R, Munn, S & Padbury, R 2016, 'Additive impact of pre-liver transplant metabolic factors on survival post-liver transplant' Journal of Gastroenterology and Hepatology (Australia), vol. 31, no. 5, pp. 1016-1024. https://doi.org/10.1111/jgh.13240

Additive impact of pre-liver transplant metabolic factors on survival post-liver transplant. / Adams, Leon; Arauz, O.; Angus, P.W.; Sinclair, M.; Macdonald, G.A.; Chelvaratnam, U.; Wigg, A.J.; Yeap, S.; Shackel, N.; Lin, L.; Raftopoulos, S.; Mccaughan, G.W.; Jeffrey, Gary; Delriviere, L.; Lynch, S.; Jones, R.; Munn, S.; Padbury, R.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 31, No. 5, 2016, p. 1016-1024.

Research output: Contribution to journalArticle

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

Y1 - 2016

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

VL - 31

SP - 1016

EP - 1024

JO - Journal of Gastroenterology and Hepatology (Australia)

JF - Journal of Gastroenterology and Hepatology (Australia)

SN - 0815-9319

IS - 5

ER -