Impact of donor diabetes mellitus status on liver transplant outcomes in patients with acute-on-chronic liver failure.
作者信息
Zhou Jie, Ye Danni, Zhang Siyao, Chen Zheng, Xu Fangshen, Ren Shenli, Zhang Yu, Zheng Huilin, Hu Zhenhua
机构信息
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, Zhejiang, China.
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Zhejiang University School of Medicine Fourth Affiliated Hospital, Yiwu, Zhejiang, China.
出版信息
Expert Rev Gastroenterol Hepatol. 2023 May;17(5):509-517. doi: 10.1080/17474124.2023.2197210. Epub 2023 Apr 10.
BACKGROUND
Liver transplantation (LT) is the most effective way to save patients with acute-on-chronic liver failure (ACLF). However, the impact of donor diabetes mellitus (DM) on LT outcomes in patients with ACLF has not been fully investigated.
RESEARCH DESIGN AND METHODS
We retrospectively analyzed data from the Scientific Registry of Transplant Recipients (SRTR) between January 1, 2008 to December 31, 2017 in this study. All the patients were divided into donors with DM and without DM group (DM: 1,394; non-DM: 11138). We compared the overall survival (OS) and graft survival (GS) across different estimated ACLF (estACLF) grades between two groups.
RESULTS
There were 25.10% estACLF-3 patients in the entire cohort. And in estACLF-3 patients, 318 patients had DM donors. The estACLF-3 associated 5-year OS rate in the non-DM group was 74.6%, significantly better than that in the DM group, with corresponding survival rate at 64.9% ( < 0.001). Donor DM was an independent predictor for OS in the entire cohort as well as in estACLF-3 patients.
CONCLUSIONS
Donor DM was associated with inferior outcomes of LT in patients with estACLF-3. However, the differences were not obvious in recipients with other estACLF grades.
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