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Diabetes Makes Lung Transplant Riskier

Fri, 06/21/2013 - 11:45am
Kristina Fiore

Patients with diabetes have poorer outcomes following a lung transplant, researchers reported.

In a retrospective study at a high-volume lung transplant center, patients with diabetes had about a five-fold increased risk of death after a lung transplant compared with transplant recipients who didn't have diabetes (HR 5.6, 95% CI 4.0-7.8, P<0.001), Kathryn Hackman, MD, of Monash University and the Alfred Hospital in Melbourne, Australia, and colleagues reported at the Endocrine Society meeting here.

"When we put together all the risk factors for death, we found irrespective of any other risk factor that diabetes was by far the most potent risk factor for death following a lung transplant," Hackman told MedPage Today. "Patients with diabetes had five times the risk of dying as patients without diabetes."

Screening lung transplant candidates for diabetes and managing the condition may be a simple way to improve outcomes for this population, she said.

Survival in lung transplant is poorer than in most other solid organ transplants, with a typical rate of 30% of patients being alive at 10 years -- compared with 60% of patients with a heart transplant and 80% of kidney transplant patients.

It's also common to develop diabetes after a lung transplant, with just over a quarter of patients (26%) developing the condition by 1 year post-transplant and 40% becoming diabetic 5 years after transplant. Yet its impact on outcomes isn't well-studied in this population, Hackman said.

She noted that her institution does most of the lung transplants in Australia and a significant proportion of lung transplants worldwide, at a rate of about 60 to 70 adult transplants per year.

To assess whether there are any differences in survival rates by diabetes status -- whether patients have type 1 or type 2 diabetes, or whether they had it before the transplant or developed it afterwards -- Hackman and colleagues conducted a review of 387 adult patients who had a lung transplant at their hospital between Jan. 1, 2001, and July 31, 2010.

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