title: New onset of diabetes after transplantation is associated with improved patient survival after liver transplantation due to confounding factor.
abstract: BACKGROUND
  The influence of NODAT on survival of liver transplant recipients has not been clarified. Therefore, we evaluated the effect of NODAT on survival in LT recipients.
  
  
  METHODS
  Data from 352 LT patients were totally analyzed. 97 patients with pretransplant diabetes mellitus were excluded, and 255 patients without diabetes mellitus at time of transplantation were included.
  
  
  RESULTS
  NODAT was diagnosed in 41 patients (16.1%). There was no difference in frequency of NODAT according to the etiology of liver cirrhosis. NODAT was associated with a higher body weight (p=0.004) and BMI (p=0.002) 5years after LT, but not with weight gain (p=0.201) or increase in BMI (p=0.335) 5years after LT. HbA1c 5years after LT was significantly higher in patients with NODAT (p=0.001), but mean HbA1c still remained lower than 6.5% (6.4(±1.2) %). Patients with NODAT showed better survival rates (log rank: p=0.002) compared to LT recipients without diabetes. According to all existing knowledge of diabetes mellitus (DM) better survival cannot be a direct effect of this disease. Our results are rather influenced by an not known confounding factor (possibly recovery from cachexia) associated with better survival and NODAT, while complications of NODAT will not appear during the relatively short postoperative time and observation period (mean follow up 6.08 (±2.67) years).
  
  
  CONCLUSIONS
  NODAT is frequently diagnosed in LT recipients and is associated with an improved 5year survival after LT due to a not exactly known confounding factor.
authors.affiliation: Hepatologie, I. Medizinische Klinik der Universitätsmedizin Mainz, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Darstein
authors.affiliation: Klinik für Kinder- und Jugendmedizin, Marienhaus Klinikum St. Elisabeth Neuwied, Germany.
authors.forename: C
authors.initials: C
authors.lastname: König
authors.affiliation: Klinik für Kinder- und Jugendmedizin, Marienhaus Klinikum St. Elisabeth Neuwied, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hoppe-Lotichius
authors.affiliation: Hepatologie, I. Medizinische Klinik der Universitätsmedizin Mainz, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Grimm
authors.affiliation: Hepatologie, I. Medizinische Klinik der Universitätsmedizin Mainz, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Knapstein
authors.affiliation: Endokrinologie und Diabetologie, I. Medizinische Klinik der Universitätsmedizin Mainz, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Zimmermann
authors.affiliation: Allgemein-, Viszeral- und Transplantationschirurgie der Universitätsmedizin Mainz, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Mittler
authors.affiliation: Hepatologie, I. Medizinische Klinik der Universitätsmedizin Mainz, Germany.
authors.forename: J M
authors.initials: JM
authors.lastname: Schattenberg
authors.affiliation: Hepatologie, I. Medizinische Klinik der Universitätsmedizin Mainz, Germany.
authors.forename: M F
authors.initials: MF
authors.lastname: Sprinzl
authors.affiliation: Hepatologie, I. Medizinische Klinik der Universitätsmedizin Mainz, Germany.
authors.forename: M A
authors.initials: MA
authors.lastname: Wörns
authors.affiliation: Allgemein-, Viszeral- und Transplantationschirurgie der Universitätsmedizin Mainz, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Lang
authors.affiliation: Hepatologie, I. Medizinische Klinik der Universitätsmedizin Mainz, Germany.
authors.forename: P R
authors.initials: PR
authors.lastname: Galle
authors.affiliation: Hepatologie, I. Medizinische Klinik der Universitätsmedizin Mainz, Germany. Electronic address: tim.zimmermann@unimedizin-mainz.de.
authors.forename: T
authors.initials: T
authors.lastname: Zimmermann
mesh_terms: D048909:Diabetes Complications / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis
keywords: Diabetes mellitus; Liver transplantation; NODAT; New onset diabetes after transplantation; Survival