title: Long-term post-liver transplant complications of renal impairment and diabetes mellitus: data from Singapore.
abstract: BACKGROUND
  Patients who survive the initial post-liver transplantation period face the development of chronic diseases in the long run. We studied two important complications of liver transplantation, namely: renal impairment and diabetes mellitus.
  
  
  METHODS
  We analysed adult patients followed-up for more than one year using data from our liver transplant clinical records. Long-term post-transplant renal impairment (RI) was defined as glomerular filtration rate (GFR) less than 60 ml/min/1.73 square metres and long-term post-transplant diabetes mellitus (DM) was defined as fasting blood glucose more than 7.8 mmol/L, that existed at least one year after liver transplantation. Pre- and post-transplant factors that could be associated with these conditions were examined.
  
  
  RESULTS
  Altogether, 35 patients were evaluated. Mean age at transplant was 50 years. Mean duration of follow-up was 58.4 months. There was 11.4 percent of pre-transplant RI and 17.0 percent of pre-transplant DM. Prevalence of post-transplant RI was 43.5 percent at one year and 45.0 percent at four years. Long-term post-transplant RI was associated with renal impairment at six months post-transplant (p-value is 0.033). Prevalence of severe post-transplant RI (GFR is less than 30 ml/min/1.73 square metres) at four years was 5.7 percent. Prevalence of post-transplant DM was 45.5 percent at two years but declined to 5.3 percent at four years.
  
  
  CONCLUSIONS
  Post-transplant renal impairment appears to be a potential long-term problem while post-transplant diabetes mellitus appears to improve with time.
authors.affiliation: Department of Gastroenterology and Hepatology, National University Hospital, 5 Lower Kent Ridge Road, Singapore.
authors.forename: D S
authors.initials: DS
authors.lastname: Sutedja
authors.forename: C T
authors.initials: CT
authors.lastname: Wai
authors.forename: K F
authors.initials: KF
authors.lastname: Teoh
authors.forename: Y M
authors.initials: YM
authors.lastname: Lee
authors.forename: R K
authors.initials: RK
authors.lastname: Diddapur
authors.forename: J
authors.initials: J
authors.lastname: Isaac
authors.forename: K
authors.initials: K
authors.lastname: Mak
authors.forename: M
authors.initials: M
authors.lastname: Da Costa
authors.forename: K H
authors.initials: KH
authors.lastname: Lee
authors.forename: K
authors.initials: K
authors.lastname: Prabhakaran
authors.forename: K C
authors.initials: KC
authors.lastname: Tan
authors.forename: S G
authors.initials: SG
authors.lastname: Lim
mesh_terms: D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology*; D012846:Singapore / Q000453:epidemiology