• Ahmed Abdallah Salman, Mohamed Abdalla Salman, Mostafa Said, Hesham Elkassar, Mohammad El Sherbiny, Ahmed Youssef, Mohammed Elbaz, Ahmed M Elmeligui, Mohamed Badr Hassan, Mahmoud Gouda Omar, Hussien Samir, Mohamed Abdelkader Morad, Hossam El-Din Shaaban, Mohamed Youssef, Ahmed Moustafa, Mohamed Sabry Tourky, Ahmed Elewa, Sadaf Khalid, Khaled Monazea, and Mohamed Shawkat.
• Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
• Ann. Med. 2022 Dec 1; 54 (1): 2598-2605.

PurposeDiabetes mellitus (DM) increases the risk of morbidity and mortality after liver resection. Albuminuria is associated with a higher risk for all-cause and cardiovascular mortality. This study evaluated albuminuria as a predictor of the outcome of living donor liver transplantation (LDLT) in patients with pre-existing DM.MethodsThis retrospective study involved 103 type II diabetic patients with end-stage liver disease who received LDLT. Preoperative spot urine albumin: creatinine ratio was used to determine the degree of albuminuria. The primary outcome measure was the impact of urinary albumin excretion on the 3-year mortality rate after LDLT in this diabetic cohort.ResultsHepatitis C virus infection was the main cause of cirrhosis. Albuminuria was detected in 41 patients (39.8%); 15 had macroalbuminuria, while 26 had microalbuminuria. Patients with microalbuminuria were significantly older than those with macroalbuminuria and normal albumin in urine. After 3 years, twenty-four patients (23.3%) died within 3 years after LT. Myocardial infarction was the leading cause of death (25%). Albuminuria was an independent factor affecting 3-year mortality with an odds ratio of 5.17 (95% CI: 1.86-14.35).ConclusionPreoperative albuminuria is an independent factor affecting mortality within 3 years after LDLT in type II diabetic patients. Myocardial infarction was the leading cause of death in 25% of cases, followed by hepatocellular carcinoma recurrence, sepsis, and graft failure.KEY MESSAGESDiabetes mellitus (DM) increases the risk of morbidity and mortality after liver resection.Albuminuria is associated with a higher risk for all-cause and cardiovascular mortality.Preoperative albuminuria is a significant predictor of mortality within 3 years after LDLT in diabetic patients.

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