S2829 Evaluating the Impact of Pre-Existing Diabetes on Liver Transplant Outcomes: A Single-Center Retrospective Study

Introduction: Diabetes mellitus (DM) is a prevalent comorbidity among liver transplant (LT) candidates and has been associated with adverse postoperative outcomes in various solid organ transplants. However, its specific impact on post-LT clinical outcomes remains incompletely characterized. This study aimed to evaluate the association between pre-transplant diabetes status and key LT outcomes. Methods: We conducted a retrospective chart review on patients 18 years and older who underwent liver transplant at our center between January 2015 -January 2023. We identified all patients with pre-transplant DM and looked at multiple transplant outcomes, including mortality, episodes of rejection, need for re-transplantation, length of hospital stay following transplant, readmission rate within 1 year following transplant, emergent initiation of dialysis within 1 week of transplant, and graft failure. Results: A total of 807 patients underwent liver transplant, 526 were men (65%) and 667 were White (83%). Among all patients, 336 (42%) had a history of diabetes mellitus. While there were no statistically significant differences between diabetic and non-diabetic patients in terms of mortality to date (23% vs 19%, P = 0.2), graft rejection (22% vs 25%, P = 0.4), graft failure (20% vs 21%, P = 0.9), or re-transplantation rates (13% vs 8.7%, P = 0.3), a significant difference was observed in the distribution of readmission frequency on the first year post-transplant (P = 0.046). Diabetic patients were more likely to experience multiple readmissions during the first year, with 17% having 3 and 22% having 4 or more readmissions, compared to 12% and 19% in non-diabetic patients, respectively. Overall readmission rates (65% vs 60%, P = 0.11) and length of hospital stay (median 11 vs 10 days, P = 0.3) were higher in diabetic patients but did not reach statistical significance. Conclusion: While diabetes mellitus was not associated with increased post-transplant mortality, graft failure, or rejection, it was significantly linked to a higher frequency of hospital readmissions within the first year after LT. These findings highlight the need for targeted perioperative care strategies and closer post-discharge monitoring in diabetic LT recipients to reduce healthcare burden and improve long-term outcomes.