Open AccessDonor liver steatosis: A risk factor for early new‐onset diabetes after liver transplantation
Author(s) -
Xue Mengjuan,
Lv Chaoyang,
Chen Xianying,
Liang Jing,
Zhao Chenhe,
Zhang Yao,
Huang Xiaowu,
Sun Qiman,
Wang Ting,
Gao Jian,
Zhou Jian,
Yu Mingxiang,
Fan Jia,
Gao Xin
Publication year - 2017
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12560
Subject(s) - medicine , liver transplantation , steatosis , cumulative incidence , hazard ratio , gastroenterology , incidence (geometry) , proportional hazards model , fatty liver , risk factor , diabetes mellitus , transplantation , confidence interval , endocrinology , disease , physics , optics
Aims/Introduction To investigate whether donor liver steatosis increases the incidence of new‐onset diabetes after transplantation ( NODAT ) in liver transplant recipients. Materials and Methods We retrospectively analyzed liver transplant recipients at Zhongshan Hospital, Shanghai, China, from April 2001 to December 2014. The final analysis involved 763 patients. The cumulative incidence of NODAT at 1, 3, 5 and 10 years after liver transplantation was investigated. Furthermore, according to the findings of donor liver biopsy before transplantation, patients were divided into steatotic and non‐steatotic donor liver groups, and NODAT incidence was compared between these groups. Multivariate Cox regression was used to explore the risk factors for NODAT in the patients. Results Of the 763 donors, 309 (40.5%) had liver steatosis. At the end of follow up, 130 (42.1%) patients in the steatotic donor liver group developed NODAT , an incidence that exceeded that in the non‐steatotic donor liver group ( P = 0.001). The cumulative incidence of NODAT among all patients at 1, 3, 5, and 10 years after transplantation was 33, 43, 50 and 56%, respectively. The cumulative incidences of NODAT at 1, 3, 5 and 10 years in the steatotic donor liver group were significantly higher than those in the non‐steatotic donor liver group ( P = 0.003). Multivariate Cox regression analyses showed that donor liver steatosis was an independent risk factor for NODAT among liver transplant recipients, after other potential risk factors were adjusted for (hazard ratio 1.774, 95% confidence interval: 1.025–3.073; P = 0.041). Conclusions Donor liver steatosis increases NODAT incidence among liver transplant recipients.