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KMID : 0361120040180010065
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Korean Journal of Transplantation
2004 Volume.18 No. 1 p.65 ~ p.72
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Clinical Review of Post-transplantation Diabetes Mellitus after Liver Transplantation
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문덕복/Moon DB
이승규/박광민/황신/김기훈/안철수/이영주/주종우/하태용/조성훈/오기봉/김연대/Lee SG/Park KM/Hwang S/Kim KH/Ahn CS/Lee YJ/Chu CW/Ha TY/Cho SH/Oh KB/Kim YD
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Abstract
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Purpose: Liver transplantation (LT) can cure abnormality of glucose metabolism, but cause altered glucose metabolism with immunosuppressive treatment. Up to now, almost all studies have been performed in cadaveric donor liver transplantation (CDLT). We underwent study in CDLT and also living donor liver transplantation (LDLT) recipients.
Methods: Among 397 adult-to-adult LT recipients between January 1994 and August 2001, we selected 81 patients who could be followed more than 12 months by using the table of random sampling numbers. We reviewed the change of blood glucose and risk factors, complications and survival retrospectively between post-transplantation diabetes mellitus (PTDM) and no PTDM patients.
Results: Clinical data showed 34 : 47 in frequency of PTDM to no PTDM. Age, family history of DM, preoperative DM history over 6 months had a significant risk of PTDM. There was no difference of PTDM frequency between CDLT and LDLT and its subgroup. The worse post-transplant graft function causes the more incidence of PTDM (P=0.051). FK506 had higher relation with PTDM than cyclosporine and mycophenolate mofetile (P=0.058). The incidence of DM after operation has been decreased by 6 months, but thereafter no further. There were 18 of De Novo DM among 34 PTDM patients, and only 1 preoperative DM patient improved after LT. Between PTDM and no PTDM group, there were no significant difference of complication rate and 5-year survival rate.
Conclusion: The types of graft would not affect the incidence of PTDM if the graft function were preserved. Other clinical data showed similar results to previous reports.
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