New-onset diabetes mellitus after living-donor liver transplantation: association with graft synthetic function.
New-onset diabetes mellitus after living-donor liver transplantation: association with graft synthetic function.
复制标题
活体肝移植后新发糖尿病：与移植物合成功能的相关性。
DOI：
10.1007/s00595-016-1444-z
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Uemoto S.
中科院分区：
文献类型：
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作者：
Yagi S;Kaido T;Iida T;Yoshizawa A;Okajima H;Uemoto S.
背景和目的目前已知死亡供体肝移植和活体肝移植（LDLT）后的移植物功能不同;然而，还没有评估移植物功能与移植后新发糖尿病（NODAT）发生之间关系的报道。我们进行了这项研究，以确定NODAT的预测风险因素，包括LDLT后的移植物功能。方法本研究的受试者是2006年至2010年在京都大学医院接受LDLT的175名成年受者，存活超过3个月结果LDLT后1年、2年和3年NODAT发生率分别为26.1%、32.0%和33.4%。移植前糖尿病与生存率低相关（p= 0.0048），而NODAT与患者生存率无关。在多因素分析中，受体年龄≥40岁，LDLT后3个月他克莫司谷浓度≥8 ng/mL，LDLT后3个月胆碱酯酶（ChE）<185 IU/L是NODAT的独立危险因素。
Background and purposeIt is now known that post-transplant graft function after deceased-donor liver transplantation and living-donor liver transplantation (LDLT) differ; however, there is no report assessing the relationship between graft function and the development of new-onset diabetes mellitus after transplantation (NODAT). We conducted this study to identify the predictive risk factors for NODAT, including graft function after LDLT.MethodsThe subjects of this study were 175 adult recipients who underwent LDLT at Kyoto University Hospital between 2006 and 2010, and survived for more than 3 months (median observation period, 1046 days).ResultsThe 1-, 2-, and 3-year incidences of NODAT after LDLT were 26.1, 32.0, and 33.4%, respectively. Pre-transplant diabetes was associated with poor survival (p= 0.0048), whereas NODAT was not associated with patient survival. In the multivariate analysis, recipient age ≥40, a tacrolimus trough level ≥8 ng/mL 3 months after LDLT, and cholinesterase (ChE) <185 IU/L 3 months after LDLT were the independent risk factors for NODAT.ConclusionsPoor graft synthetic function 3 months after LDLT as well as older age of the recipient and a higher tacrolimus concentration were strongly associated with NODAT development after LDLT.