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The impact of post-transplant diabetes mellitus on liver transplant outcomes.

Publication ,  Journal Article
Lieber, SR; Lee, R-A; Jiang, Y; Reuter, C; Watkins, R; Szempruch, K; Gerber, DA; Desai, CS; DeCherney, GS; Barritt, AS
Published in: Clinical transplantation
June 2019

Post-transplant diabetes mellitus (PTDM) is common after liver transplantation (LT). Yet, how PTDM relates to graft outcomes and survival needs elucidation as more individuals are transplanted for nonalcoholic fatty liver disease (NAFLD).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.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.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.

Duke Scholars

Published In

Clinical transplantation

DOI

EISSN

1399-0012

ISSN

0902-0063

Publication Date

June 2019

Volume

33

Issue

6

Start / End Page

e13554

Related Subject Headings

  • Survival Rate
  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Prognosis
  • Postoperative Complications
  • North Carolina
  • Middle Aged
  • Male
  • Liver Transplantation
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lieber, S. R., Lee, R.-A., Jiang, Y., Reuter, C., Watkins, R., Szempruch, K., … Barritt, A. S. (2019). The impact of post-transplant diabetes mellitus on liver transplant outcomes. Clinical Transplantation, 33(6), e13554. https://doi.org/10.1111/ctr.13554
Lieber, Sarah R., Ruth-Ann Lee, Yue Jiang, Claire Reuter, Randall Watkins, Kristen Szempruch, David A. Gerber, Chirag S. Desai, G Stephen DeCherney, and A Sidney Barritt. “The impact of post-transplant diabetes mellitus on liver transplant outcomes.Clinical Transplantation 33, no. 6 (June 2019): e13554. https://doi.org/10.1111/ctr.13554.
Lieber SR, Lee R-A, Jiang Y, Reuter C, Watkins R, Szempruch K, et al. The impact of post-transplant diabetes mellitus on liver transplant outcomes. Clinical transplantation. 2019 Jun;33(6):e13554.
Lieber, Sarah R., et al. “The impact of post-transplant diabetes mellitus on liver transplant outcomes.Clinical Transplantation, vol. 33, no. 6, June 2019, p. e13554. Epmc, doi:10.1111/ctr.13554.
Lieber SR, Lee R-A, Jiang Y, Reuter C, Watkins R, Szempruch K, Gerber DA, Desai CS, DeCherney GS, Barritt AS. The impact of post-transplant diabetes mellitus on liver transplant outcomes. Clinical transplantation. 2019 Jun;33(6):e13554.
Journal cover image

Published In

Clinical transplantation

DOI

EISSN

1399-0012

ISSN

0902-0063

Publication Date

June 2019

Volume

33

Issue

6

Start / End Page

e13554

Related Subject Headings

  • Survival Rate
  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Prognosis
  • Postoperative Complications
  • North Carolina
  • Middle Aged
  • Male
  • Liver Transplantation