HEART TRANSPLANTATION IN DIABETIC RECIPIENTS
https://doi.org/10.15825/1995-1191-2018-1-120-126
Abstract
Diabetes mellitus is one of the most prevalent chronic metabolic disorders. Its role in patients with heart transplantation is not unifi ed. According to some authors, post-transplantation diabetes mellitus increases the risk of acute rejections and infections, increases the incidence of coronary artery disease of the graft and reduces long-term survival of patients with heart transplantation. On the other hand other studies did not confi rm these fi ndings. However, when diabetic patients were stratifi ed by disease severity, recipients with less severe disease achieved better survival. Accordingly, posttransplant survival was not signifi cantly different between recipients with uncomplicated diabetes and nondiabetic recipients. Diabetes alone should not be a contraindication to heart transplantation. Well-selected diabetic patients achieve the same survival as nondiabetic patients. Conversely, patients with complicated diabetes have signifi cantly worse survival. Therefore, given the critical shortage of transplantable organs, maximal benefi t may be achieved by exploring alternative treatment options in individuals with severe diabetes. These include use of high-risk transplant lists and destination therapy.
About the Authors
V. N. Poptsov
V.I. Shumakov National Medical Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Poptsov Vitaly Nicolaevich
1, Shchukinskaya st., Moscow, 123182
E. N. Zolotova
V.I. Shumakov National Medical Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation
Russian Federation
Moscow
Russian Federation
Moscow
References
1. Dedov II, Shestakova MV, Vikulova OK. Epidemiology of diabetes mellitus in Russian Federation: clinical and statistical report according to the federal diabetes registry. Diabetes Mellitus. 2017; 20 (1): 13–41.
2. Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002; 287: 2570–2581.
3. Erqou S, Lee CT, Suffoletto M, Echouffo-Tcheugui JB, de Boer RA, van Melle JP, Adler AI. Association between glycated haemoglobin and the risk of congestive heart failure in diabetes mellitus: systematic review and metaanalysis. Eur. J. Heart. Fail. 2013; 15: 185–193.
4. Driel DL, Sweitzer NK, Drazner MH et al. Prognostic impacts of diabetes mellitus in patients with heart failure to the etiology of left ventricular systolic dysfunction. J. Am. Coll. Cardiol. 2001; 38: 421–428.
5. Perrone-Filardi P, Paolillo S, Costanzo P, Savarese G, Trimarco B, Bonow RO. The role of metabolic syndrome in heart failure. Eur. Heart. J. 2015; 36: 2630–2634.
6. Goray TY, Leibson CL, Palumbo PJ et al. Coronary atherosclerosis in diabetes mellitus: a population-based autopsy study. J. Am. Coll. Cardiol. 2002; 40: 946–953.
7. Miller L. Heart transplantation in patients with diabetes. Circulation. 2006; 114 (21): 2206–2207.
8. Marelli D, Laks H, Patel B et al. Heart transplantation in patients with diabetes mellitus in the current era. J. Heart. Lung. Transplant. 2003; 22: 1091–1097.
9. Körner MM, Tenderich G, Mannebach H et al. Extended donor criteria: current donors with a history of prolonged insulin-dependent diabetes mellitus. Transplant Proc. 1997; 29: 3664–3666.
10. Ikeda Y, Tenderich G, Zittermann A et al. Heart transplantation in insulin-treated diabetic patients with diabetesrelated complications. Transplant International. 2007; 20: 528–533.
11. Meyer SR, Modry DL, Norris CM et al. Pretransplant diabetes, not donor age, predicts long-term outcomes in cardiac transplantation. J. Card. Surg. 2006; 21: 117–124.
12. Valantine H. Cardiac allograft vasculopathy after heart transplantation: risk factor and management. J. Heart. Lung. Transplant. 2004; 23: S187–S193.
13. Rasco AG, Sobrino Márquez JM, Nevado Portero J et al. Impact of overweight on survival and primary graft failure after heart transplantation. Transplant Proc. 2010; 42: 3178–3180.
14. Cabrol C, Gandjbakhch I, Pavie A, Cabrol A et al. Heart transplantation. Experience at La Pitié hospital. Apropos of 82 cases. Arch. Mal. Couer. Vaiss. 1984; 77: 1427– 1433.
15. Gandjbakhch I, Rottembourg J, Conseiller С et al. Choice of recipient in human cardiac transplantation. Nouv. Press. Med. 1975; 4: 867–870.
16. Higgins J, Pfl ugfelder PW, Kostuk WJ. Increased morbidity in diabetic cardiac transplant recipients. Can. J. Cardiol. 2009; 25: e125–e129.
17. Mohamedali B, Yost G, Bhat G. Is Diabetes Mellitus a Risk Factor for Poor Outcomes after Left Ventricular Assist Device Placement? Tex. Heart. Inst. J. 2017; 44: 115–119.
18. António N, Prieto D, Providência LA, Antunes MJ. Diabetes mellitus does not affect one-year outcome after heart transplantation. Rev. Port. Cardiol. 2010; 29: 205– 220.
19. Garcia C, Wallia A, Gupta S et al. Intensive glycemic control after heart transplantation is safe and effective for diabetic and non-diabetic patients. Clin. Transplant. 2013; 27: 444–454.
20. Ladowski JS, Kormos RL, Uretsky BF, Griffi th BP et al. Heart transplantation in diabetic recipients. Transplantation. 1990; 49: 303–305.
21. Munoz E, Lonquist JL, Radovancevic B et al. Long-term results in diabetic patients undergoing heart transplantation. J. Heart. Lung. Transplant. 1992; 11: 943–949.
22. Saraiva J, Sola E, Prieto D, Antunes MJ. Diabetes as an outcome predictor after heart transplantation. Interact. Cardiovasc. Thorac. Surg. 2011; 13: 499–504.
23. Rhenman MJ, Rhenman B, Icenogle T et al. Diabetes and heart transplantation. J. Heart. Transplant. 1988; 7: 356–358.
24. Livi U, Caforio AL, Grassi G et al. Mid-term results of heart transplantation in diabetic patients. J. Cardiovasc. Surg (Torino). 1994; 35: 115–118.
25. Russo MJ, Chen JM, Hog KM et al. Survival after heart transplantation is not diminished among recipients with uncomplicated diabetes mellitus (an analysis of the United Network of Organ Sharing database. Circulation. 2006; 114: 2280–2287.
26. Morgan JA, John R, Weinberg AD et al. Heart transplantation in diabetic recipients: a decade review of 161 patients at Colombia Presbyterian. J. Thorac. Cardiovasc. Surg. 2004; 127: 1486–1492.
27. Griepp RB. A decade of human heart transplantation. Transplant. 1979; 11: 285–292.
28. Narrod J, Kormos R, Armitage J et al. Acute rejection and coronary artery disease in long-term survivors of heart transplantation. J. Heart. Transplant. 1989; 8: 418–420.
29. Chen JM, Russo MJ, Hammond KM et al. Alternate waiting list strategies for heart transplantation maximize donor organ utilization. Ann. Thorac. Surg. 2005; 80: 224–228.
30. Baldwin RT, Radovancevic B, Sweeney MS et al. Bacterial mediastinitis after heart transplantation. J. Heart. Lung. Transplant. 1992; 11: 545–549.
31. Carrier M, Hudon G, Paquet E et al. Mediastinal and pericardial complications after heart transplantation. Notsounusual postoperative problems? Cardiovasc. Surg. 1994; 2: 395–397.
32. Sénéchal M, LePrince P, Tezenas du Montcel S et al. Bacterial mediastinitis after heart transplantation: clinical presentation, risk factors and treatment. J. Heart. Lung. Transplant. 2004; 23: 165–170.
33. McGeown MG, Douglas JF, Brown WA et al. Low dose steroid from the day following renal transplantation. Proc. Eur. Dial. Transplant. Assoc. 1979; 16: 395–400.
34. Livi U, Luciani GB, Boffa GM et al. Clinical results of steroid-free induction immunosuppression after heart transplantation. Ann. Thorac. Surg. 1993; 55: 1160– 1165.
35. Kligenberg R, Gleissner C, Koch A et al. Impact of preoperative diabetes mellitus upon early and late survival after heart transplantation: a possible era effect. J. Heart. Lung. Transplant. 2005; 24: 1239–1246.
Review
For citations:
Poptsov V.N., Zolotova E.N. HEART TRANSPLANTATION IN DIABETIC RECIPIENTS. Russian Journal of Transplantology and Artificial Organs. 2018;20(1):120-126. (In Russ.) https://doi.org/10.15825/1995-1191-2018-1-120-126
Views:
1588
Email this article 