초록접수 현황
| 21F-124 | 구연 발표 |
Impact of Post-transplant Diabetes Mellitus (PTDM) on Clinical Outcomes in Patients Undergoing Isolated Heart Transplantation
Won Kyung Pyo1, Dong-Ju Choi2, Eun-Seok Jeon3, Hae-Young Lee2, Hyun-Jai Cho2, Jae-Joong Kim4, Jaewon Oh5, Jin Joo Park6, Jin-Oh Choi3, Sung-Ho Jung1
1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine
2. Department of Internal Medicine, Seoul National University College of Medicine
3. Department of Internal Medicine,Samsung Medical Center, Sungkyunkwan University College of Medicine,
4. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine
5. Department of Internal Medicine, Yonsei University College of Medicine, Seoul,
6. Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital
Purpose : The aim of this study is to describe impact of post-transplant diabetes mellitus (PTDM), which may predispose solid organ recipients into greater risk of mortality or graft failure, on clinical outcomes after heart transplantation (HTPL) using Korean Organ Transplantation Registry data.
Methods : We identified consecutive 379 non-diabetic patients (aged 53.0±13.8 years, 136 females) undergoing first time isolated HTPL between 2014 and 2019. Of these, 109 patients were complicated with PTDM (PTDM group), whereas remainder (n=270) had no DM developed (No-DM group). The clinical outcomes were compared using landmark analysis.
Results : A median time to onset of PTDM was 31 days (interquartile range, 30-39 days). The PTDM group was older (p<0.001), more male dominant (p=0.034) and had higher preoperative glucose level (p=0.001) compared to No-DM group. During follow-up (931.2 patient-year [PY]), 43 patients died (4.6% PY). PTDM was not associated with increased risk for overall mortality (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.47-2.50), and survival at 3-years was 90.5±3.3% and 87.5±2.1% in PTDM and No-DM group, respectively. PTDM group presented a significantly greater risk of moderate or severe rejection (hazard ratio [HR], 1.87; 95% confidence interval [CI], 1.32-2.63) and infection requiring hospitalization (HR,1.46; 95% CI, 1.05-2.04) compared to No-DM group. No differences in the overall stroke or cardiac allograft vasculopathy rates were evident between the groups.
Conclusion : Although PTDM had no negative effect on overall survival, it was associated with increased risk of graft rejection and infection in patients undergoing HTPL. A rigorous glycemic control may be needed to improve post-transplantation outcomes.
Methods : We identified consecutive 379 non-diabetic patients (aged 53.0±13.8 years, 136 females) undergoing first time isolated HTPL between 2014 and 2019. Of these, 109 patients were complicated with PTDM (PTDM group), whereas remainder (n=270) had no DM developed (No-DM group). The clinical outcomes were compared using landmark analysis.
Results : A median time to onset of PTDM was 31 days (interquartile range, 30-39 days). The PTDM group was older (p<0.001), more male dominant (p=0.034) and had higher preoperative glucose level (p=0.001) compared to No-DM group. During follow-up (931.2 patient-year [PY]), 43 patients died (4.6% PY). PTDM was not associated with increased risk for overall mortality (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.47-2.50), and survival at 3-years was 90.5±3.3% and 87.5±2.1% in PTDM and No-DM group, respectively. PTDM group presented a significantly greater risk of moderate or severe rejection (hazard ratio [HR], 1.87; 95% confidence interval [CI], 1.32-2.63) and infection requiring hospitalization (HR,1.46; 95% CI, 1.05-2.04) compared to No-DM group. No differences in the overall stroke or cardiac allograft vasculopathy rates were evident between the groups.
Conclusion : Although PTDM had no negative effect on overall survival, it was associated with increased risk of graft rejection and infection in patients undergoing HTPL. A rigorous glycemic control may be needed to improve post-transplantation outcomes.
책임저자: Sung-Ho Jung
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine
발표자: Won Kyung Pyo, E-mail : buguimoran@gmail.com