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(Circulation. 2006;114:2206-2207.)
© 2006 American Heart Association, Inc.

Editorial

Heart Transplantation in Patients With Diabetes

Leslie Miller, MD

From Georgetown University and Washington Hospital Center, Minneapolis, Minn.

Correspondence to Leslie Miller, MD, Georgetown University and Washington Hospital Center, 420 Delaware St MMC 508, Minneapolis, MN 55455. E-mail mille278@umn.edu

Key Words: complications • diabetes mellitus • heart failure • transplantation

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The superior survival rate and average improvement in functional capacity associated with heart transplantation have made it the optimal therapeutic option for selected patients with end-stage heart failure. The current average survival rate of 80% to 85% at 1 year after transplantation and 60% to 65% at 5 years after transplantation far exceeds that reported for any other type of medical or surgical treatment for this population of patients.¹ However, the outcomes with this procedure are not uniform and are influenced significantly by the presence of comorbidities such as end-organ dysfunction, malnutrition, and overall functional status at the time of the procedure.

Article p 2280

Diabetes mellitus (DM) is a disease that is increasing at alarming rates in the US population. The progression of vascular and other complications correlates in part with the length of time that the disease has been present, especially the duration of need for insulin therapy, but also with the level of glucose control. Poor glucose control and onset of disease under the age of 20 years are often associated with progressive target-organ dysfunction (particularly renal failure) and coronary, cerebral, and peripheral vascular disease, with MI, stroke, claudication/amputations, and blindness in advanced cases. DM has become the No. 1 cause of renal failure, dialysis, and kidney transplantation.² It is also estimated that DM may be present in >40% of patients with heart failure, either as a primary contributor to coronary artery disease and atherosclerosis or a common secondary comorbidity.³

The limited number of available cardiac donors . . . [Full Text of this Article]