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Post-transplant diabetes mellitus in pediatric liver transplantation

Eba Hathout1, Estella Alonso, Ravinder Anand

  • 1Division of Pediatric Endocrinology and Diabetes, Loma Linda University, Loma Linda, CA 92354, USA. ehathout@llu.edu

Pediatric Transplantation
|January 9, 2008
PubMed

Insights

Pediatric liver transplant recipients over age 5, hospitalized at transplant, or on early steroids/tacrolimus face higher risks of gastrointestinal issues and post-transplant diabetes mellitus (PTDM). Monitoring is crucial for early detection and management.

Area of Science:

  • Pediatric Gastroenterology
  • Transplant Hepatology
  • Immunology

Background:

  • Gastrointestinal (GI) complications and post-transplant diabetes mellitus (PTDM) are significant concerns in pediatric liver transplantation.
  • Identifying risk factors is essential for proactive management and improving outcomes in this vulnerable population.

Purpose of the Study:

  • To identify recipient and donor characteristics associated with the development of GI and/or PTDM in children undergoing their first liver transplant.
  • To analyze factors contributing to early-onset GI/PTDM within 30 days post-transplantation.

Main Methods:

  • Analysis of data from 1611 pediatric patients undergoing their first liver transplant, sourced from the SPLIT database.
  • Evaluation of recipient factors (age, hospitalization, diagnosis, immunosuppression) and donor factors (type, age, CMV status).
  • Multivariate analyses to determine statistically significant associations with GI/PTDM development.

Main Results:

  • Gastrointestinal issues and/or PTDM occurred in 13% (214/1611) of pediatric liver transplant recipients.
  • Early GI/PTDM (within 30 days) was diagnosed in 78% (166/214) of affected individuals.
  • Factors associated with increased early GI/PTDM incidence included: age >5 years at transplant, hospitalization at transplant, primary diagnosis other than biliary atresia, early steroid use, and tacrolimus use.

Conclusions:

  • Age, hospitalization status, specific primary diagnoses, and early immunosuppressive strategies (steroids, tacrolimus) are key predictors of early GI/PTDM after pediatric liver transplant.
  • Routine monitoring for GI complications and PTDM is recommended for comprehensive short- and long-term care of pediatric liver transplant recipients.

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