New-onset diabetes after adult liver transplantation in the Korean Organ Transplantation Registry (KOTRY) study
- 주제(키워드) Diabetes , living donors , immunosuppression , Asia
- 주제(기타) Gastroenterology & Hepatology
- 주제(기타) Nutrition & Dietetics
- 주제(기타) Surgery
- 설명문(일반) [Kim, Jong Man] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Surg, Seoul, South Korea; [Hwang, Shin] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Surg, Ulsan, South Korea; [Lee, Kwang-Woon] Seoul Natl Univ, Coll Med, Dept Surg, Seoul, South Korea; [Lee, Jae-Geun; Kim, Myoung Soo] Yonsei Univ, Coll Med, Dept Surg, 50 Yonsei Ro, Seoul 03722, South Korea; [Ryu, Je Ho] Pusan Natl Univ, Coll Med, Dept Surg, Busan, South Korea; [Kim, Bong-Wan] Ajou Univ, Sch Med, Dept Liver Transplantat & Hepatobiliary Surg, Suwon, South Korea; [Choi, Dong Lak] Catholic Univ Daegu, Coll Med, Dept Surg, Daegu, South Korea; [You, Young Kyoung] Catholic Univ Korea, Coll Med, Dept Surg, Seoul, South Korea; [Kim, Dong-Sik] Korea Univ, Coll Med, Dept Surg, Div HBP Surg & Liver Transplantat, Seoul, South Korea; [Nah, Yang Won] Univ Ulsan, Coll Med, Ulsan Univ Hosp, Dept Surg, Ulsan, South Korea; [Kang, Koo Jeong] Keimyung Univ, Sch Med, Dept Surg, Daegu, South Korea; [Cho, Jai Young] Seoul Natl Univ, Coll Med, Bundang Hosp, Dept Surg, Sungnam, South Korea; [Hong, Geun] Ewha Womans Univ, Sch Med, Dept Surg, Seoul, South Korea; [Choi, In Seok] Konyang Univ Hosp, Dept Surg, Daejon, South Korea; [Yu, Hee Chul] Chonbuk Natl Univ, Sch Med, Dept Surg, Jeonju, South Korea; [Choi, Dongho] Hanyang Univ, Coll Med, Dept Surg, Seoul, South Korea
- 등재 SCIE
- OA유형 gold, Green Published
- 발행기관 AME PUBL CO
- 발행년도 2020
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000172422
- 본문언어 영어
- Published As https://dx.doi.org/10.21037/hbsn.2019.10.29
- PubMed https://pubmed.ncbi.nlm.nih.gov/32832494
초록/요약
Background: New-onset diabetes after transplantation (NODAT) is a serious complication following liver transplantation (LT). The present study aimed to investigate the incidence of and risk factors for NODAT using the Korean Organ Transplantation Registry (KOTRY) database. Methods: Patients with history of pediatric transplantation (age <= 18 years), re-transplantation, multi-organ transplantation, or pre-existing diabetes mellitus were excluded. A total of 1,919 non-diabetic adult patients who underwent a primary LT between May 2014 and December 2017 were included. Risk factors were identified using Cox regression analysis. Results: NODAT occurred in 19.7% (n=377) of adult liver transplant recipients. Multivariate analysis showed steroid use, increased age, and high body mass index (BMI) in recipients, and implantation of a leftside liver graft was closely associated with NODAT in adult LT. In living donor liver transplant (LDLT) patients (n=1,473), open donor hepatectomy in the living donors, steroid use, small for size liver graft (graft to recipient weight ratio <= 0.8), increased age, and high BMI in the recipient were predictive factors for NODAT. The use of antimetabolite and basiliximab induction reduced the incidence of NODAT in adult LT and in adult LDLT. Conclusions: Basiliximab induction, early steroid withdrawal, and antimetabolite therapy may prevent NODAT after adult LT. High BMI or advanced age in liver recipients, open donor hepatectomy in living donors, and small size liver graft can predict the occurrence of NODAT after adult LT or LDLT.
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