{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:38:29Z","timestamp":1784259509881,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T00:00:00Z","timestamp":1642550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We investigated the current trends and outcomes of diabetic patients listed for heart transplants in the U.S. and provided a method for risk\u2010stratification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from the United Network for Organ Sharing (UNOS), we identified heart failure patients listed for heart transplants between 2010 and 2019. Diabetic patients were propensity\u2010matched with non\u2010diabetics, and waitlist mortality as well as post\u2010transplant graft survival were compared between the two groups. Further risk\u2010stratification of diabetic patients was done based on the risk factors that independently predict graft failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>28,928 adult patients (30% diabetic) with end\u2010stage heart failure were added to the waitlist over the study period. In the propensity\u2010matched cohort, waitlist mortality was higher in diabetic patients compared to non\u2010diabetics (HR\u00a0=\u00a01.13 (95% CI\u00a0=\u00a01.04\u20101.22, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002). Over the study period, 5739 patients with diabetes were transplanted. In the propensity\u2010matched cohorts of transplant recipients, the rate of graft failure was significantly higher for diabetic patients (23.3%) compared to non\u2010diabetics (20.4%); HR\u00a0=\u00a01.17, 95% CI\u00a0=\u00a01.08\u20101.26, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001. We identified 12 risk factors of graft failure among diabetic patients and developed a risk score that further risk\u2010stratify these patients. Diabetic patients at low risk (score\u22644) had similar graft survival as patients without diabetes (HR\u00a0=\u00a0.91, 95% CI\u00a0=\u00a0.82\u20101.01, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.06). On the other hand, high\u2010risk diabetic patients had worse graft survival compared to non\u2010diabetics (HR\u00a0=\u00a01.52, 95% CI\u00a0=\u00a01.38\u20101.67, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among patients with end\u2010stage heart failure, pre\u2010existing diabetes was associated with higher waitlist mortality and worse graft survival. However, with careful patient selection, graft survival is similar to those without diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14590","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T09:53:06Z","timestamp":1641981186000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of diabetic patients with end\u2010stage heart failure listed for heart transplantation: A propensity\u2010matched analysis"],"prefix":"10.1111","volume":"36","author":[{"given":"Emmanuel","family":"Akintoye","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular, and Thoracic Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulino","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Division of Heart failure and Cardiac Transplantation Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7618-5983","authenticated-orcid":false,"given":"Mohamed","family":"Salih","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Sellke","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-9670","authenticated-orcid":false,"given":"Alexandros","family":"Briasoulis","sequence":"additional","affiliation":[{"name":"Division of Heart Failure and Transplant University of Iowa Hospitals and Clinics  Iowa Iowa USA"},{"name":"National Kapodestrian University of Athens, Medical 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