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Prevalence, predictive factors, and survival outcome of new-onset diabetes after liver transplantation

View Article: PubMed Central - PubMed

ABSTRACT

The aim of the present nationwide population-based cohort study was to explore the prevalence, risk factors, and survival outcome of new-onset diabetes (NOD) in recipients after liver transplantation.

The National Health Insurance Research Database of Taiwan was searched for ICD-9-codes, 2248 patients who had received liver transplant without pretransplant diabetes from July 1, 1998 to December 31, 2012 were included in the study. The preoperative risks factors were considered and analyzed using logistic regression analysis, following adjustments for age and sex. All patients were followed up until the end of the study or death.

The final dataset included 189 patients with NOD and 2059 without diabetes after liver transplantation. The prevalence of NOD was 8.4% and in 64% NOD appeared in the first year after liver transplantation. Preoperative clinical events, alcoholic liver cirrhosis, and hepatic encephalopathy were the most important risk factors for NOD after liver transplantation. The mortality rate was lower in NOD recipients than in non-NOD recipients within 5 years.

In this study, we provide evidence that NOD recipients had better 5-year survival outcomes in this clinical population. The most important identifiable predictive factors for NOD after liver transplantation were alcoholic hepatitis, ascites, hepatic coma, and esophageal varices.

No MeSH data available.


Related in: MedlinePlus

Five-year patient survival curves of NODALT by unadjusted Kaplan-Meier curves. NODALT = new-onset diabetes after liver transplantation.
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Figure 3: Five-year patient survival curves of NODALT by unadjusted Kaplan-Meier curves. NODALT = new-onset diabetes after liver transplantation.

Mentions: A total of 24 patients with NOD and 300 patients without NOD died during the study period. Mortality rates at 6 months, 1 year, 3 years, 5 years, 7 years, 9 years, 11 years, and overall (14.5 years) are reported in Table 5. There was no significant difference at the overall (14.5 years) survival rate in patients with or without NOD (P = 0.1203) (Table 5). However, Kaplan-Meier survival curves showed survival rate have significant difference (P = 0.0209) among 3 patients groups (Fig. 3). There were a higher 5-year survival rate in patients with NOD than patients without NOD (P = 0.0190) and with diabetes before transplantation (P = 0.0041). However, there was no significant difference between patients without NOD and with diabetes before transplantation (P = 0.2564). For avoiding liver cancers bias, 114 patients with post-transplantation liver cancer in non-NOD recipients and 11 patients with post-transplantation liver cancer in NOD recipients were excluded. The Kaplan-Meier survival analysis also showed a higher 5-year survival rate in patients with NOD than without NOD (P = 0.0063) (Fig. S1).


Prevalence, predictive factors, and survival outcome of new-onset diabetes after liver transplantation
Five-year patient survival curves of NODALT by unadjusted Kaplan-Meier curves. NODALT = new-onset diabetes after liver transplantation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998307&req=5

Figure 3: Five-year patient survival curves of NODALT by unadjusted Kaplan-Meier curves. NODALT = new-onset diabetes after liver transplantation.
Mentions: A total of 24 patients with NOD and 300 patients without NOD died during the study period. Mortality rates at 6 months, 1 year, 3 years, 5 years, 7 years, 9 years, 11 years, and overall (14.5 years) are reported in Table 5. There was no significant difference at the overall (14.5 years) survival rate in patients with or without NOD (P = 0.1203) (Table 5). However, Kaplan-Meier survival curves showed survival rate have significant difference (P = 0.0209) among 3 patients groups (Fig. 3). There were a higher 5-year survival rate in patients with NOD than patients without NOD (P = 0.0190) and with diabetes before transplantation (P = 0.0041). However, there was no significant difference between patients without NOD and with diabetes before transplantation (P = 0.2564). For avoiding liver cancers bias, 114 patients with post-transplantation liver cancer in non-NOD recipients and 11 patients with post-transplantation liver cancer in NOD recipients were excluded. The Kaplan-Meier survival analysis also showed a higher 5-year survival rate in patients with NOD than without NOD (P = 0.0063) (Fig. S1).

View Article: PubMed Central - PubMed

ABSTRACT

The aim of the present nationwide population-based cohort study was to explore the prevalence, risk factors, and survival outcome of new-onset diabetes (NOD) in recipients after liver transplantation.

The National Health Insurance Research Database of Taiwan was searched for ICD-9-codes, 2248 patients who had received liver transplant without pretransplant diabetes from July 1, 1998 to December 31, 2012 were included in the study. The preoperative risks factors were considered and analyzed using logistic regression analysis, following adjustments for age and sex. All patients were followed up until the end of the study or death.

The final dataset included 189 patients with NOD and 2059 without diabetes after liver transplantation. The prevalence of NOD was 8.4% and in 64% NOD appeared in the first year after liver transplantation. Preoperative clinical events, alcoholic liver cirrhosis, and hepatic encephalopathy were the most important risk factors for NOD after liver transplantation. The mortality rate was lower in NOD recipients than in non-NOD recipients within 5 years.

In this study, we provide evidence that NOD recipients had better 5-year survival outcomes in this clinical population. The most important identifiable predictive factors for NOD after liver transplantation were alcoholic hepatitis, ascites, hepatic coma, and esophageal varices.

No MeSH data available.


Related in: MedlinePlus