Association of Smoking Habits with Comorbidity 15 Years After Liver Transplantation.
1University Transplant Center, University Hospital Hamburg Eppendorf, Hamburg, Germany
2Department of Hepatobiliary Surgery and Transplantation, University Hospital Hamburg Eppendorf, Hamburg, Germany
3Department of Medicine, University Hospital Hamburg Eppendorf, Hamburg, Germany.
Meeting: 2016 American Transplant Congress
Abstract number: D176
Keywords: Immunosuppression, Liver transplantation, Renal dysfunction
Session Information
Date: Tuesday, June 14, 2016
Session Name: Poster Session D: Liver: Immunosuppression and Rejection
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background and aims
The survival rate of liver transplant (OLT) recipients has strongly improved over the last years. Here we investigate the association between long term morbidity and the smoking habits of transplanted patients.
Methods
A retrospective analysis of all adult OLT recipients who were transplanted at our center between 1997 and 1999 and survived more than 15 years was performed.
Results
53 patients (47% female) were included in the analysis. Patient's age 15 years after transplantation ranged between 31 and 80 years (median 65 years). 22.6 % are treated with Tacrolimus (initially 11%), 55% with Cyclosporine (initially 72%), 23% with steroids (initially 83%), 4% with Azathioprine (initially 32%), 49% with MMF (initially 30.2), 9.5% with Sirolimus and 11% with Everolimus.
Fifteen years post OLT graft function assessed by GGT, ALT and bilirubin was within normal limits in 65% of smokers and 60% of non-smokers. Altogether, 81% of long-term survivors suffered from hypertension, 26% from hyperlipidemia, 22% diabetes mellitus, 32% hyperuricemia, 9% had cardiovascular and 6% cerebrovascular events. Furthermore, 15% developed a solid malignant tumor, 15% skin cancer, 6% PTLD. There was no association between the occurrence of cardiovascular risk factors, cardio-vascular events or the development of a malignant disease and the smoking habits of the patients.
Median (47.5ml/min) GFR estimated by MDRD ranged from 16 to 117 ml/min. Chronic kidney disease stage 4 was observed in 39% of smokers versus 14% of non-smokers. Also median creatinine was significantly higher in smokers than in non-smokers (median 1.6mg/dl versus 1.2mg/dl, p=0.011) and GFR decline from pre transplant values to 15 years post transplant values was significantly higher in smokers (GFR decline 40 ml/min versus 16 ml/min, p=0.032)
Conclusion
This study revealed a high incidence of comorbidities in long term OLT recipients. Smoking was significantly associated with impaired renal function, but not with the development of malignant diseases or cardiovascular complications.
CITATION INFORMATION: Pischke S, Lege M, Fischer L, Herden U, Lohse A, Nashan B, Sterneck M. Association of Smoking Habits with Comorbidity 15 Years After Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Pischke S, Lege M, Fischer L, Herden U, Lohse A, Nashan B, Sterneck M. Association of Smoking Habits with Comorbidity 15 Years After Liver Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/association-of-smoking-habits-with-comorbidity-15-years-after-liver-transplantation/. Accessed March 4, 2021.« Back to 2016 American Transplant Congress