title: Incidence and risk factors for new-onset diabetes in living-donor liver transplant recipients.
abstract: With the increased number of long-term survivors after liver transplantation, new-onset diabetes after transplantation (NODAT) is becoming more significant in patient follow-up. However, the incidence of new-onset diabetes after living-donor liver transplantation (LDLT) has not been well elucidated. The aim of this study was to evaluate the incidence and risk factors for NODAT in adult LDLT recipients at a single center in Japan. A retrospective study was performed on 161 adult patients without diabetes who had been followed up for ≥three months after LDLT. NODAT was defined according to the 2003 American Diabetes Association/World Health Organization guidelines. The recipient-, donor-, operation-, and immunosuppression-associated risk factors for NODAT were assessed. Overall, the incidence of NODAT was 13.7% (22/161) with a mean follow-up of 49.8 months. In a multivariate analysis, the identified risk factors for NODAT were donor liver-to-spleen (L-S) ratio (hazard ratio [HR] = 0.022, 95% confidence interval [CI] = 0.001-0.500, p = 0.017), and steroid pulse therapy for acute rejection (HR = 3.320, 95% CI = 1.365-8.075, p = 0.008). In conclusion, donor L-S ratio and steroid pulse therapy for acute rejection were independent predictors for NODAT in LDLT recipients. These findings can help in screening for NODAT and applying early interventions.
authors: Department of Transplantation and Pediatric Surgery, Postgraduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors: Masaki
authors: M
authors: Honda
authors: Katsuhiro
authors: K
authors: Asonuma
authors: Shintaro
authors: S
authors: Hayashida
authors: Hiroko
authors: H
authors: Suda
authors: Yuki
authors: Y
authors: Ohya
authors: Kwang-Jong
authors: KJ
authors: Lee
authors: Hidekazu
authors: H
authors: Yamamoto
authors: Takayuki
authors: T
authors: Takeichi
authors: Yukihiro
authors: Y
authors: Inomata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology* / Q000209:etiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D017741:Survivors; D055815:Young Adult