title: Diabetes mellitus after liver transplantation: prevalence and predictive factors.
abstract: OBJECTIVE
  To investigate the prevalence and risk factors for the development of diabetes mellitus after orthotopic liver transplantation, we reviewed 27 variables (including previous history of diabetes mellitus, data related to pre-transplant liver disease, and postoperative events) in 102 patients who survived longer than 1 year after orthotopic liver transplantation.
  
  
  RESULTS
  Fourteen patients had diabetes mellitus prior to liver transplantation and all but one were alive 2 and 3 years after transplantation, with all survivors continuing to have diabetes mellitus 1, 2 and 3 years after transplantation. Among the 88 patients without pre-transplant diabetes mellitus, the prevalence of post-transplant diabetes mellitus was 27% at 1 year, 9% at 2 years and 7% at 3 years, probably related to a significant reduction in the daily prednisone dose (13 +/- 4 mg at 1 year, 7 +/- 6 mg at 2 years and 2 +/- 4 mg at 3 years, p < 0.001). Patients with post-transplant diabetes mellitus 1 year after transplantation had a higher number of rejection episodes during the first postoperative year than those without post-transplant diabetes mellitus (1.5 +/- 1.1 vs 1.1 +/- 0.7, p < 0.05) and also had higher, but not statistically significant, cumulative steroid dose and blood cyclosporine levels. Mortality of patients with post-transplant diabetes mellitus was significantly higher during the second postoperative year in comparison with patients without post-transplant diabetes mellitus: 4/24 vs 2/64 (17% vs 3%; p < 0.05).
  
  
  CONCLUSIONS
  Liver transplantation does not significantly modify pre-transplant diabetes mellitus. Diabetes mellitus frequently develops de novo after liver transplantation, although this complication is usually transient and probably related to immunosuppressive drug administration. The prognosis of patients with post-transplant diabetes mellitus is worse than that of those without this complication.
authors.affiliation: Liver Unit, Hospital Clínic i Provincial, University of Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Navasa
authors.forename: J
authors.initials: J
authors.lastname: Bustamante
authors.forename: C
authors.initials: C
authors.lastname: Marroni
authors.forename: E
authors.initials: E
authors.lastname: González
authors.forename: H
authors.initials: H
authors.lastname: Andreu
authors.forename: E
authors.initials: E
authors.lastname: Esmatjes
authors.forename: J C
authors.initials: JC
authors.lastname: García-Valdecasas
authors.forename: L
authors.initials: L
authors.lastname: Grande
authors.forename: I
authors.initials: I
authors.lastname: Cirera
authors.forename: A
authors.initials: A
authors.lastname: Rimola
authors.forename: J
authors.initials: J
authors.lastname: Rodés
mesh_terms: D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors
chemical_list: D016572:Cyclosporine