Diabetes is an independent risk factor for cancer after heart and/or lung transplantation

GND
1180648404
Affiliation
Department of Cardiothoracic Surgery, Jena University Hospital, 07743 Jena, Germany;(H.K.);(A.M.);(T.C.);(I.S.);(G.F.);(T.S.)
Kirov, Hristo;
Affiliation
Department of Cardiothoracic Surgery, Jena University Hospital, 07743 Jena, Germany;(H.K.);(A.M.);(T.C.);(I.S.);(G.F.);(T.S.)
Moschovas, Alexandros;
GND
1242046895
Affiliation
Department of Cardiothoracic Surgery, Jena University Hospital, 07743 Jena, Germany;(H.K.);(A.M.);(T.C.);(I.S.);(G.F.);(T.S.)
Caldonazo, Tulio;
Affiliation
Department of Cardiothoracic Surgery, Jena University Hospital, 07743 Jena, Germany;(H.K.);(A.M.);(T.C.);(I.S.);(G.F.);(T.S.)
Schwan, Imke;
GND
128690275
Affiliation
Department of Cardiothoracic Surgery, Jena University Hospital, 07743 Jena, Germany;(H.K.);(A.M.);(T.C.);(I.S.);(G.F.);(T.S.)
Faerber, Gloria;
Affiliation
Department of Cardiothoracic Surgery, Jena University Hospital, 07743 Jena, Germany;(H.K.);(A.M.);(T.C.);(I.S.);(G.F.);(T.S.)
Sandhaus, Tim;
GND
1216191093
Affiliation
Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, 07743 Jena, Germany;
Lehmann, Thomas;
GND
120602571
Affiliation
Department of Cardiothoracic Surgery, Jena University Hospital, 07743 Jena, Germany;(H.K.);(A.M.);(T.C.);(I.S.);(G.F.);(T.S.)
Doenst, Torsten

Background: De novo cancers are feared complications after heart or lung transplantation. Recent data suggest that diabetes mellitus (DM) might also be a risk factor for cancer. We hypothesized that transplanted diabetic patients are at greater risk of developing cancer compared to non-diabetic ones. Methods: We reviewed 353 patients post-heart and/or -lung transplantation from our center between October 1999 and June 2021. Patients with follow-up <180 days ( n = 87) were excluded from the analysis. The remaining 266 patients were divided into patients who had preoperative DM (n = 88) or developed it during follow-up ( n = 40) and patients without DM ( n = 138). Results: The diabetic cohort showed higher rates of malignancies in all patients (30.33 vs. 15.97%, p = 0.005) and in the matched population (31.9 vs. 16.1%, p < 0.001). There were also significantly more solid tumors (17.9 vs. 9.4%, p = 0.042; matched: 16.6 vs. 9.1%, p = 0.09) The presence of diabetes was associated with a 13% increased risk of cancer when compared to non-diabetic patients. New-onset post-transplant diabetes doubled the likelihood of cancer development. Conclusions: Pre-transplant diabetes mellitus increases the risk of cancer after heart and/or lung transplantation. However, new-onset diabetes after transplantation is associated with a much greater cancer risk. This information is relevant for screening during follow-up.

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