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New‐onset diabetes after liver transplantation: a national report from China Liver Transplant Registry
Author(s) -
Ling Qi,
Xu Xiao,
Xie Haiyang,
Wang Kai,
Xiang Penghui,
Zhuang Runzhou,
Shen Tian,
Wu Jian,
Wang Weilin,
Zheng Shusen
Publication year - 2016
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13042
Subject(s) - liver transplantation , medicine , diabetes mellitus , china , transplantation , endocrinology , political science , law
Background/Aims New‐onset diabetes after transplantation ( NODAT ) is a serious complication of liver transplantation ( LT ). The present study aimed to investigate the risk factors of NODAT by a national survey using the China Liver Transplant Registry database. Patients A total of 10 204 non–pre‐existing diabetic patients undergone primary LT between January 2000 and December 2013 were included. Risk factors were identified by logistic regression analysis. Results NODAT occurred in 24.3% of liver recipients with a median follow‐up time of 2.6 years, and was associated with a significantly lower patient survival. NODAT increased not only diabetes related complications (e.g., infection, kidney failure) but also biliary stricture and cholangitis. NODAT patients who received hypoglycaemic treatment had a worse prognosis and a higher hepatocellular carcinoma recurrence compared with those without treatment. New‐onset hyperglycaemia (<30 days) was the major predictor of NODAT . Other risk factors included cold ischaemia time >9 h, recipient age >50 years, body mass index >25 kg/m 2 , other hepatitis (mainly hepatitis C), post‐transplant intensive care unit stay >15 days, cytomegalovirus infection and corticosteroid at discharge. Conclusions The incidence of NODAT in China is similar to that in Western countries. However, the NODAT ‐related complications are more common and severer in China compared with those in Western countries. The major risk factors are different.