Abstract | BACKGROUND: METHODS: This single-center, retrospective study of adult LT recipients (2003-2016) identified PTDM incidence and associations with graft steatosis, rejection, and post-LT patient survival. Multivariable analysis investigated predictors of PTDM. Kaplan-Meier curves depicted patient survival 5 years post-LT. RESULTS: Among 415 adult LT recipients, 23% had pre-LT DM and 13% were transplanted for NAFLD. PTDM incidence was 34.7%, 46.9%, and 56.2% and overall survival was 90%, 80.9%, and 71.7% at 1, 3, and 5 years, respectively. Over a third of non- NAFLD patients developed PTDM. Half of PTDM cases developed by 6 months and 75% by 12 months. The PTDM group had more rejection episodes compared to no PTDM (31.9% vs 21.8%, P = 0.055), with trends toward worse patient survival 5 years post-LT (log-rank test P = 0.254). Age was the only significant predictor of PTDM. CONCLUSIONS: Post-transplant diabetes mellitus occurs rapidly in the post-LT period and is a significant problem for both NAFLD and non- NAFLD LT recipients. Age is a significant risk factor for PTDM. Outcomes trended toward increased rejection and worse survival among PTDM individuals, suggesting the benefit of early strategies targeting glucose control.
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Authors | Sarah R Lieber, Ruth-Ann Lee, Yue Jiang, Claire Reuter, Randall Watkins, Kristen Szempruch, David A Gerber, Chirag S Desai, G Stephen DeCherney, A Sidney Barritt 4th |
Journal | Clinical transplantation
(Clin Transplant)
Vol. 33
Issue 6
Pg. e13554
(06 2019)
ISSN: 1399-0012 [Electronic] Denmark |
PMID | 30927288
(Publication Type: Clinical Trial, Journal Article, Research Support, N.I.H., Extramural)
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Copyright | © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. |
Topics |
- Adult
- Diabetes Mellitus
(epidemiology, mortality, physiopathology)
- Female
- Follow-Up Studies
- Graft Rejection
(etiology, mortality, pathology)
- Graft Survival
- Humans
- Incidence
- Liver Diseases
(mortality, surgery)
- Liver Transplantation
(adverse effects, mortality)
- Male
- Middle Aged
- North Carolina
(epidemiology)
- Postoperative Complications
(etiology, mortality, pathology)
- Prognosis
- Retrospective Studies
- Risk Factors
- Survival Rate
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