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New-onset diabetes after adult liver transplantation in the Korean Organ Transplantation Registry (KOTRY) study

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Affiliated Author(s)
강구정
Alternative Author(s)
Kang, Koo Jeong
Journal Title
HepatoBiliary Surgery and Nutrition
ISSN
2304-389X
Issued Date
2020
Keyword
Diabetesliving donorsimmunosuppressionAsia
Abstract
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 left-side 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.
Department
Dept. of Surgery (외과학)
Publisher
School of Medicine (의과대학)
Citation
Jong Man Kim et al. (2020). New-onset diabetes after adult liver transplantation in the Korean Organ Transplantation Registry (KOTRY) study. HepatoBiliary Surgery and Nutrition, 9(4), 425–439. doi: 10.21037/hbsn.2019.10.29
Type
Article
ISSN
2304-389X
DOI
10.21037/hbsn.2019.10.29
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43090
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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