Risk factors associated with diabetes after liver transplant.

Area of Science:

• Transplantation Medicine
• Metabolic Complications
• Hepatology

Background:

• Post-transplant diabetes mellitus (PTDM) is a frequent metabolic complication following liver transplantation.
• PTDM significantly impairs recipient survival and liver graft function.
• Identifying PTDM risk factors is essential for improved patient outcomes.

Purpose of the Study:

• To identify independent risk factors associated with the development of diabetes mellitus after liver transplantation.
• To analyze risk factors for both pre-existing diabetes mellitus and new-onset PTDM.

Main Methods:

• A cross-sectional study involving 207 liver transplant recipients from September to November 2019.
• Patients were categorized into three groups: no diabetes mellitus, pre-transplant diabetes mellitus, and PTDM.
• Data collected via chart review, including patient demographics, transplant indications, immunosuppressive agents, and histological findings. Multivariate logistic regression was employed for risk factor analysis.

Main Results:

• Cirrhosis due to alcohol, hepatitis C, and triglyceride levels were identified as independent risk factors for overall diabetes mellitus.
• Independent risk factors specifically for PTDM included cirrhosis due to alcohol, hepatitis C, and exposure to prednisone.
• Higher tacrolimus exposure was noted in non-diabetic patients, while ciclosporin use was higher in those with pre-transplant diabetes. Steatosis was more prevalent in recipients with pre-transplant diabetes.

Conclusions:

• Alcoholic cirrhosis is a significant risk factor for developing PTDM in liver transplant recipients.
• Liver transplant recipients with a history of alcoholic cirrhosis, hepatitis C, or prednisone exposure require vigilant PTDM screening.
• Proactive monitoring and management strategies are recommended for high-risk liver transplant patients to mitigate PTDM development and its consequences.