Recent Advances in TransplantationLiver transplantationNew-Onset Diabetes Mellitus in Liver Transplant Recipients With Hepatitis C: Analysis of the National Database

- This study is based on the largest registry data set on liver transplantation.
- We found several modifiable risk factors for new-onset diabetes mellitus (NODM) in HCV recipients.
- Our results could be applied to clinical practice directly to decrease the morbidity of NODM.

BackgroundNew-onset diabetes mellitus (NODM) after liver transplantation (LT) occurs with increased frequency in recipients with hepatitis C virus (HCV). We compared the incidence and risk factors for NODM in HCV vs non-HCV recipients.MethodsAmong 24,956 liver recipients, 18,741 without pretransplantation diabetes were identified. NODM-free survival was analyzed using Kaplan-Meier and log-rank tests, and risk factors for NODM were examined using multivariate Cox regression analysis.ResultsThe overall incidence of NODM was 13.0% at 1 year after LT. At 1, 2, 3, and 5 years after LT, incidence of NODM in HCV recipients was 14.4%, 4.3%, 3.1%, and 3.5%, respectively, compared with 11.9%, 3.5%, 3.2%, and 6.4%, respectively, in non-HCV recipients. HCV recipients had a higher risk of NODM than non-HCV recipients (hazard ratio 1.17 [1.09-1.27], P < .001). Predictors of NODM in HCV recipients were age, body mass index (BMI), tacrolimus and steroid usage at discharge, acute rejection episode, and donor with diabetes mellitus. Risk factors in non-HCV recipients were male recipient, BMI, and recipients with nonalcoholic steatohepatitis diagnosis.ConclusionsHCV recipients have a higher incidence and more risk factors for NODM than non-HCV recipients. Early identification of modifiable risk factors will assist clinical interventions to prevent NODM complications after LT.