ENDO 2013: The Endocrine Society 95th Annual Meeting & Expo:

Diabetes Increases Risk for Death After Lung Transplant

This is the first study to determine diabetes as a risk factor for mortality after lung transplantation. Kathryn L. Hackman, MD of Monash University, and a Visiting Endocrinologist at The Alfred Hospital in Melbourne, Australia led the study revealing diabetics have a 5.6 fold increased risk of death after lung transplant.

The files and pathology test results of 386 patients who underwent lung transplantation at The Alfred during the period 2001 through 2010 were evaluated. Patients were categorized by diabetes mellitus (DM) status before and after lung transplantation. Nineteen patients were excluded from the study because their DM status was either unknown or transient. The median survival of the remaining 367 patients was assessed by DM category.

Patients without DM

  • 67 of the 171 patients died (39%)
  • Median survival: 3677 days


Patients with new onset DM post lung transplantation

  • Increased mortality rate: 59%
  • Median survival: 1583 days


Patients with pre- and post- lung transplantation DM

  • Increased mortality rate: 49%
  • Median survival: 1834 days


Multivariate Analyses

Other factors included use of cyclosporine instead of tacrolimus, and baseline triglycerides. Protective factors were donors and recipients who were negative for cytomegalovirus, cystic fibrosis, and bronchiectasis. The length of time patients spent on the lung transplant waitlist, their age, sex, history of smoking, or BMI did not predict survival.

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