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糖尿病与65岁以上肝移植患者术后较差的短期预后无关。

Diabetes mellitus is not associated with worse short term outcome in patients older than 65 years old post-liver transplantation.

作者信息

Alghamdi Saad, Alamro Shaden, Alobaid Dhari, Soliman Elwy, Albenmousa Ali, Bzeizi Khalid Ibrahim, Alabbad Saleh, Alqahtani Saleh A, Broering Dieter, Al-Hamoudi Waleed

机构信息

Liver and Small Bowel Health Centre Department, KFSHRC, Riyadh 11211, Saudi Arabia.

Department of Medicine, KFSHRC, Riyadh 11211, Saudi Arabia.

出版信息

World J Hepatol. 2023 Feb 27;15(2):274-281. doi: 10.4254/wjh.v15.i2.274.

Abstract

BACKGROUND

Non-alcoholic fatty liver disease is a global health care challenge and a leading indication of liver transplantation (LT). Hence, more patients with diabetes mellitus (DM) are undergoing LT, especially, above the age of 65.

AIM

To evaluate the impact of DM on short-term outcomes post-LT in patients over the age of 65.

METHODS

We collected data of patients who underwent LT from January 2001 until December 2019 using our electronic medical record. We assessed the impact of DM on short-term outcomes, one-year, post-LT based on the following variables: Survival at one year; acute cellular rejection (ACR) rates; intensive care unit (ICU) and hospital length of stay; and readmissions.

RESULTS

Total of 148 patients who are 65 year or older underwent LT during the study period. The mean age is 68.5 ± 3.3 years and 67.6% were male. The median Model for End-stage Liver Disease score at time of transplantation was 22 (6-39), 39% of patients had hepatocellular carcinoma and 77.7% underwent living donor LT. The one-year survival was similar between DM patients and others, 91%. ACR occurred in 13.5% of patients ( = 0.902). The median ICU stay is 4.5-day = 0.023. The rates of ICU and 90-d readmission were similar ( = 0.821) and ( = 0.194), respectively.

CONCLUSION

The short-term outcome of elderly diabetic patients undergoing LT is similar to others. The presence of DM in elderly LT candidates should not discourage physicians from transplant consideration in this cohort of patients.

摘要

背景

非酒精性脂肪性肝病是一项全球性的医疗保健挑战,也是肝移植(LT)的主要指征。因此,越来越多的糖尿病(DM)患者正在接受肝移植,尤其是65岁以上的患者。

目的

评估糖尿病对65岁以上患者肝移植术后短期结局的影响。

方法

我们使用电子病历收集了2001年1月至2019年12月期间接受肝移植患者的数据。我们基于以下变量评估糖尿病对肝移植术后一年短期结局的影响:一年生存率;急性细胞排斥反应(ACR)发生率;重症监护病房(ICU)和住院时间;以及再入院情况。

结果

在研究期间,共有148名65岁及以上的患者接受了肝移植。平均年龄为68.5±3.3岁,67.6%为男性。移植时终末期肝病模型评分中位数为22(6 - 39),39%的患者患有肝细胞癌,77.7%的患者接受了活体供肝肝移植。糖尿病患者和其他患者的一年生存率相似,均为91%。13.5%的患者发生了急性细胞排斥反应(P = 0.902)。ICU住院时间中位数为4.5天(P = 0.023)。ICU再入院率和90天再入院率分别相似(P = 0.821)和(P = 0.194)。

结论

老年糖尿病患者肝移植的短期结局与其他患者相似。老年肝移植候选患者中糖尿病的存在不应阻碍医生对该类患者进行移植考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/528d/10011905/83eb877c2135/WJH-15-274-g001.jpg

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