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New research: diabetes key to transplant success

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19 June 2013

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Better management of diabetes could have highly beneficial outcomes for lung transplant patients.

Better management of diabetes could dramatically improve outcomes for lung transplant patients, with new research showing that those without diabetes lived twice as long as transplant recipients with the disease.

In a study presented at ENDO 2013 - the Annual Meeting and Expo of the American Endocrine Society - researchers led by Dr Kathryn Hackman of Monash University analysed lung transplant patient data over 10 years. They found that those with diabetes, whether diagnosed before or after the operation, had a five-fold greater risk of dying. 

Data were examined from 386 lung transplants performed at The Alfred Hospital between 2001 and 2010. Analysis showed that the average survival period for patients with diabetes was five years, compared with 10 years for those who did not have the condition.

Dr Hackman, who is completing her PhD at Monash University and is an endocrinologistat The Alfred, said that causes of death were the same for all lung transplant recipients, irrespective of their diabetes status.

"The patients with diabetes were not dying of stroke, cardiovascular disease or other diabetes-related illnesses. The main cause of death in all transplant patients was a lung condition known as bronchiolitis obliterans, which is a form of chronic rejection of the transplanted organ," Dr Hackman said.

"This suggests that diabetes could be affecting the transplanted lungs and causing them to fail earlier."

Dr Hackman said that diabetes screening had previously not been a routine aspect of post-transplant care, but that this approach is now being rethought. 

“Only 30 per cent of lung transplant recipients survive beyond ten years. It was thought that the effects of diabetes, which manifest in the longer term, would not be significant to the health of these patients. However, our research suggests that diabetes is not a side issue, it's a critical issue for lung transplant patients," Dr Hackman said.

"We have the knowledge and the means to easily and effectively manage diabetes. It's quite possible that we could significantly improve the outlook for lung transplant patients."

Co-investigators on the study included Monash University professors Gregory Snell, also Head of Lung Transplant Service at The Alfred and Leon Bach, who is also the Deputy Director of the Department of Endocrinology and Diabetes The Alfred. The team will now confirm the effect of diabetes management on lung transplant patients through further clinical research.

The study was supported by the Monash Faculty of Medicine, Nursing and Health Sciences and The Alfred Research Trust.