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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Diabetes mellitus is not associated with worse short term outcome in patients older than 65 years old post-liver transplantation
Saad Alghamdi, Shaden Alamro, Dhari Alobaid, Elwy Soliman, Ali Albenmousa, Khalid Ibrahim Bzeizi, Saleh Alabbad, Saleh A Alqahtani, Dieter Broering, Waleed Al-Hamoudi
Saad Alghamdi, Elwy Soliman, Ali Albenmousa, Khalid Ibrahim Bzeizi, Saleh Alabbad, Saleh A Alqahtani, Dieter Broering, Waleed Al-Hamoudi, Liver and Small Bowel Health Centre Department, KFSHRC, Riyadh 11211, Saudi Arabia
Shaden Alamro, Dhari Alobaid, Department of Medicine, KFSHRC, Riyadh 11211, Saudi Arabia
Elwy Soliman, Department of Internal Medicine, Minia University, Minya 61519, Egypt
Saleh A Alqahtani, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States
Waleed Al-Hamoudi, Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
Author contributions: Alghamdi S, Bzeizi KI, Alabbad S, Alqahtani SA, Broering D and Al-Hamoudi W contributed equally to this work; Alghamdi S, Alamro S, Alobaid D and Soliman E designed the research study; Alghamdi S, Alamro S, Alobaid D, Soliman E, Albenmousa A, Bzeizi KI and Al-Hamoudi W analyzed the data and wrote the manuscript; Alghamdi S, Albenmousa A, Bzeizi KI, Alqahtani SA and Al-Hamoudi W performed the research; Alghamdi S, Bzeizi KI, and Al-Hamoudi W contributed new reagents and analytic tools; All authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the King Faisal Specialist Hospital and Research Center Institutional Review Board.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at mdisaad@kfshrc.edu.sa.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Saad Alghamdi, MD, Doctor, Liver and Small Bowel Health Centre Department, KFSHRC, Altakhassusi Road, Riyadh 11211, Saudi Arabia. mdisaad@kfshrc.edu.sa
Received: August 5, 2022
Peer-review started: August 5, 2022
First decision: October 20, 2022
Revised: November 24, 2022
Accepted: January 18, 2023
Article in press: January 18, 2023
Published online: February 27, 2023
BACKGROUND
Non-alcoholic fatty liver disease is a global health care challenge and a leading indication of liver transplantation (LT). Hence, more patients with diabetes mellitus (DM) are undergoing LT, especially, above the age of 65.
AIM
To evaluate the impact of DM on short-term outcomes post-LT in patients over the age of 65.
METHODS
We collected data of patients who underwent LT from January 2001 until December 2019 using our electronic medical record. We assessed the impact of DM on short-term outcomes, one-year, post-LT based on the following variables: Survival at one year; acute cellular rejection (ACR) rates; intensive care unit (ICU) and hospital length of stay; and readmissions.
RESULTS
Total of 148 patients who are 65 year or older underwent LT during the study period. The mean age is 68.5 ± 3.3 years and 67.6% were male. The median Model for End-stage Liver Disease score at time of transplantation was 22 (6-39), 39% of patients had hepatocellular carcinoma and 77.7% underwent living donor LT. The one-year survival was similar between DM patients and others, 91%. ACR occurred in 13.5% of patients (P = 0.902). The median ICU stay is 4.5-day P = 0.023. The rates of ICU and 90-d readmission were similar (P = 0.821) and (P = 0.194), respectively.
CONCLUSION
The short-term outcome of elderly diabetic patients undergoing LT is similar to others. The presence of DM in elderly LT candidates should not discourage physicians from transplant consideration in this cohort of patients.
Core Tip: Diabetes mellitus (DM) is very common in elderly patients who are candidates for liver transplant. In a single center experience, DM did not affect the short term outcome in elderly patients who underwent liver transplantation (LT). Hepatitis C virus and non-alcoholic steatohepatitis were the leading indications for LT. Majority of patients in this study had living liver donors.
