Clinical characteristics of new-onset diabetes after liver transplantation and outcomes.

Authors

Shingo Shimada, Henry Ford HealthFollow
Katsunori Miyake, Henry Ford HealthFollow
Deepak Venkat, Henry Ford HealthFollow
Humberto C. Gonzalez, Henry Ford HealthFollow
D Moonka, Henry Ford HealthFollow
Atsushi Yoshida, Henry Ford HealthFollow
Marwan S. Abouljoud, Henry Ford HealthFollow
Shunji Nagai, Henry Ford HealthFollow

Recommended Citation

Shimada S, Miyake K, Venkat D, Gonzalez H, Moonka D, Yoshida A, Abouljoud M, and Nagai S. Clinical characteristics of new-onset diabetes after liver transplantation and outcomes. Ann Gastroenterol Surg 2024.

Document Type

Article

Publication Date

5-1-2024

Publication Title

Ann Gastroenterol Surg

Abstract

BACKGROUND: We aimed to identify the characteristics of new-onset diabetes after liver transplantation (LT) (NODAT) and investigate its impacts on post-transplant outcomes.

METHODS: Adult LT patients between 2014 and 2020 who used tacrolimus as initial immunosuppression and survived 3 months at least were evaluated. Patients who developed NODAT within 3 months after LT were classified as NODAT group. Also, patients were further classified as history of diabetes before LT (PHDBT) and non-diabetes (ND) groups. Patient characteristics, post-LT outcomes, and cardiovascular and/or pulmonary complications were compared.

RESULTS: A total of 83, 225, and 263 patients were classified into NODAT, PHDBT, and ND groups. The proportion of cholestatic liver disease and rejection within 90 days were higher in NODAT group. Mean serum tacrolimus concentration trough level in the first week after LT was 7.12, 6.12, and 6.12 ng/mL (p < 0.001). Duration of corticosteroids was significantly longer in NODAT compared to PHDBD or ND (416, 289, and 228 days, p < 0.001). Three-year graft and patient survival were significantly worse in NODAT than ND (80.5% vs. 95.0%, p < 0.001: 82.0% vs. 95.4%, p < 0.001) but similar to PHDBT. Adjusted risks of 3-year graft loss and patient death using Cox regression analysis were significantly higher in NODAT compared to ND (adjusted hazard ratio [aHR] 3.41, p = 0.004; aHR 3.61, p = 0.004). Incidence rates of cardiovascular or pulmonary complications after LT in NODAT were significantly higher than ND but similar to PHDBT.

CONCLUSION: Higher initial tacrolimus concentration and early rejection might be risk factors for NODAT. NODAT was associated with worse post-transplant outcomes.

PubMed ID

38707230

ePublication

ePub ahead of print

Volume

8

Issue

3

First Page

383

Last Page

393