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Diabetes should not rule out a heart transplant

/ Source: The Associated Press

Diabetics who don't have other health problems survive heart transplants about as well as nondiabetics, according to a new study, which suggests diabetes shouldn't disqualify patients from a transplant waiting list.

"It actually reinforces the approach that we've taken for 20 years, that diabetes without major complications ... does not exclude transplantation," said Dr. W. Steves Ring, chairman of cardiovascular and thoracic surgery at the University of Texas Southwestern in Dallas. Ring, who heads up heart transplant programs at three Dallas area hospitals, was not involved in the study.

While national rules do not prevent diabetics from getting heart transplants, each transplant center has its own rules.

A spokeswoman with the United Network for Organ Sharing, which helps coordinate organ distribution, said the network doesn't know what criteria individual transplant centers use. She said 135 U.S. hospitals offer heart transplants.

Dr. John Buse, president-elect of the American Diabetes Association, said he believes that rules automatically denying heart transplants to diabetics was something that may have been more common in the past.

For the study, published online Monday in the American Heart Association journal Circulation, researchers analyzed UNOS records for survival rates of more than 20,000 people who had heart transplants between 1995 and 2005. That included 3,687 people who were diabetic.

The researchers found that nondiabetics had a median survival rate of 10.1 years, while diabetics had a survival rate of 9.3 years, a difference the study authors said was not statistically significant.

About 21 million Americans suffer from diabetes, mostly Type 2, which is linked to obesity. The disease, which significantly increases the risk for heart disease and stroke, is often associated with other cardiovascular risk factors, including high blood pressure, cholesterol problems and insulin resistance.

And more people are developing heart failure, said one of the study authors, Dr. Mark Russo, a researcher at Columbia University. A transplant is often the only solution for heart failure, when the weakened heart gradually loses its pumping power.

Russo said the study confirms doctors' intuition. While showing that many diabetics do well with a heart transplant, the research also showed that median survival for those with one complicating condition of diabetes fell to under 7 years and for those with two complications, transplant survival was under 4 years.

"Prior to this it was unclear whether diabetes mattered and what it meant if they had complications related to their diabetes," Russo said.