Heart transplantation in patients with type II diabetes Mellitus

ABSTRACTIntroduction: The risk of infections and failure of other organs can complicate the evolution of the diabetic patient who receives a heart transplant. The experience of a group of diabetic patients who received a heart transplant is presented.Objective: To analyze the evolution, complications, and survival of diabetic patients receiving heart transplants.Material and methods: Diabetic patients receiving heart transplants between October 1, 2010, and April 30, 2020, were selected. We analyzed age, sex, time of evolution with diabetes and treatment received, additional risk factors, presence of exacerbation of these complications, rejection reactions, post-transplant diabetes, infections, survival, and mortality and its causes. Results: During the period analyzed, 181 heart transplants were performed; of these, 29 (16.02%) were performed in patients with diabetes mellitus. The predominant sex was male, and the indication for transplantation was ischemic cardiomyopathy; the time of evolution of diabetes was 10.2 years, and most patients were receiving treatment with oral hypoglycemic agents. As a cause of mortality, infections were predominant in the early and late postoperative stages, graft failure was predominant in the perioperative period, and graft vasculopathy was the cause of death after one year after transplantation. The highest number of deaths occurred in men (83.3%). The mean follow-up was 5.4 ± 2.95 years (range: 1-9 years). Conclusion: When comparing the results with other series, we conclude that diabetic patients with end-stage heart failure can receive a heart transplant if there is strict metabolic control.