Loebe M, Ramasubbu K, Hamilton D J
Direktor Lungentransplantation, Department of Surgery, Baylor College of Medicine, 6560 Fannin Suite 1860, Houston TX 77030, USA.
Clin Res Cardiol. 2006 Jan;95 Suppl 1:i48-53. doi: 10.1007/s00392-006-1121-0.
Diabetes is frequently encountered in patients presenting with end-stage heart failure to be listed for transplantation. While diabetes used to be a contra-indication for heart transplantation, careful preoperative evaluation and individualized postoperative medication lead to long-term outcome after heart transplantation equal to non-diabetic patients. About 1/3 of transplanted patients develop a post-transplant diabetes. Several risk factors have been identified leading to this condition. Mostly, post-transplant diabetes is of temporary nature. Several studies have shown no impact of diabetes on the incidence of rejection, malignancies, and transplant vasculopathy. However, glucose intolerance must be taken into consideration when planing immunosuppressive therapy since different medications have distinct impact on glucose metabolism after transplant. A multidisciplinary team allows for closely monitoring and treating patients with diabetes after heart transplant.
糖尿病在因终末期心力衰竭而等待心脏移植的患者中很常见。虽然糖尿病曾是心脏移植的禁忌证,但术前仔细评估和个体化术后用药使心脏移植后的长期预后与非糖尿病患者相当。约1/3的移植患者会发生移植后糖尿病。已确定了导致这种情况的几个危险因素。大多数情况下,移植后糖尿病是暂时的。多项研究表明,糖尿病对排斥反应、恶性肿瘤和移植血管病变的发生率没有影响。然而,在规划免疫抑制治疗时必须考虑葡萄糖不耐受情况,因为不同药物对移植后葡萄糖代谢有不同影响。多学科团队能够对心脏移植后的糖尿病患者进行密切监测和治疗。