TY - JOUR
T1 - A simplified multivisceral transplantation procedure for patients with combined end-stage liver disease and type 2 diabetes mellitus
AU - He, Xiao Shun
AU - Fu, Shun Jun
AU - Zhao, Qiang
AU - Zhu, Xiao Feng
AU - Wang, Dong Ping
AU - Han, Ming
AU - Ju, Wei Qiang
AU - Ma, Yi
AU - Jiao, Xing Yuan
AU - Yuan, Xiao Peng
AU - Hu, An Bin
AU - Guo, Zhi Yong
N1 - Funding Information:
This study was supported by the National Natural Science Foundation of China (81373156 and 81471583), the Special Fund for Science Research by Ministry of Health (201302009), the Guangdong Provincial Key Laboratory Construction Projection on Organ Donation and Transplant Immunology (2013A061401007), the Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation) (2015B050501002), Pearl River Nova Program of Guangzhou (201506010014), Special support program for training high-level talents in Guangdong Province (2015TQ01R168), and Guangdong Provincial Natural Science Funds for Distinguished Young Scholars (2015A030306025). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2017 by the American Association for the Study of Liver Diseases.
PY - 2017/9
Y1 - 2017/9
N2 - In liver transplant patients with type 2 diabetes mellitus (DM), the disease worsens after transplantation because of longterm use of diabetogenic immunosuppressive drugs, making management of those patients a great challenge. The objective of our study was to evaluate the safety and efficacy of a simplified multivisceral transplantation (SMT) procedure for the treatment of patients with end-stage liver disease and concurrent type 2 DM. Forty-four patients who had pretransplant type 2 DM were included. A total of 23 patients received SMT, and 21 patients received orthotopic liver transplantation (OLT). Patient and graft survivals, complications, diabetic control, and quality of life (QOL) were retrospectively analyzed in both groups. The 1-, 3-, and 5-year cumulative patient and graft survival rates were 91.5%, 75.4%, and 75.4% in the SMT group and were 94.4%, 64.4%, and 64.4% in the OLT group, respectively (P = 0.70). Interestingly, 95.7% (22/23) of patients achieved complete remission from DM after SMT compared with 16.7% (3/18) of patients after OLT. The occurrence of biliary complication was significantly higher in the OLT group than that in the SMT group (23.8% versus 0.0%; P = 0.01). Moreover, better QOL was observed in the SMT group than that in the OLT group. In conclusion, the SMT procedure we described here is a safe and viable option for patients with end-stage live disease and concurrent type 2 DM. This SMT procedure offers excellent transplant outcomes and QOL. Liver Transplantation 23 1161–1170 2017 AASLD.
AB - In liver transplant patients with type 2 diabetes mellitus (DM), the disease worsens after transplantation because of longterm use of diabetogenic immunosuppressive drugs, making management of those patients a great challenge. The objective of our study was to evaluate the safety and efficacy of a simplified multivisceral transplantation (SMT) procedure for the treatment of patients with end-stage liver disease and concurrent type 2 DM. Forty-four patients who had pretransplant type 2 DM were included. A total of 23 patients received SMT, and 21 patients received orthotopic liver transplantation (OLT). Patient and graft survivals, complications, diabetic control, and quality of life (QOL) were retrospectively analyzed in both groups. The 1-, 3-, and 5-year cumulative patient and graft survival rates were 91.5%, 75.4%, and 75.4% in the SMT group and were 94.4%, 64.4%, and 64.4% in the OLT group, respectively (P = 0.70). Interestingly, 95.7% (22/23) of patients achieved complete remission from DM after SMT compared with 16.7% (3/18) of patients after OLT. The occurrence of biliary complication was significantly higher in the OLT group than that in the SMT group (23.8% versus 0.0%; P = 0.01). Moreover, better QOL was observed in the SMT group than that in the OLT group. In conclusion, the SMT procedure we described here is a safe and viable option for patients with end-stage live disease and concurrent type 2 DM. This SMT procedure offers excellent transplant outcomes and QOL. Liver Transplantation 23 1161–1170 2017 AASLD.
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U2 - 10.1002/lt.24774
DO - 10.1002/lt.24774
M3 - Article
C2 - 28422396
AN - SCOPUS:85027711111
SN - 1527-6465
VL - 23
SP - 1161
EP - 1170
JO - Liver Transplantation
JF - Liver Transplantation
IS - 9
ER -