The impact of diabetes mellitus and glycemic control on clinical outcomes following liver transplant for hepatitis C.

Abstract:

:Hepatitis C is the leading indication for liver transplantation in the USA and recurrence is universal. The impact of preexisting diabetes, new-onset diabetes after transplant (NODAT), and glycemic control on fibrosis progression has not been studied. This retrospective longitudinal cohort study included adult liver recipients with hepatitis C transplanted between 2000 and 2011. Patients were divided into three groups: preexisting diabetes (n = 41), NODAT (n = 59), and no diabetes (n = 103). Patients with preexisting diabetes (70%) or NODAT (59%) were more likely to develop hepatitis C recurrence (≥stage 1 fibrosis), as compared to non-diabetics (36%, p = 0.006). There was also a trend toward a higher incidence of at least Stage 2 fibrosis (36% and 48% vs. 23%, respectively; p = 0.063). Patients with tight glycemic control had a lower rate of Stage 2 fibrosis development (78% vs. 60%, p = 0.027), while those with good control (<150 mg/dL) also had lower rates of Stage 2 fibrosis (84% vs. 62%, p = 0.004). Multivariable analysis verified a decreased rate of recurrence for patients with blood glucose <138 mg/dL (p = 0.021), after controlling for confounders. These results demonstrate that diabetes is strongly associated with an increased risk of hepatitis C virus-related fibrosis development and glycemic control may reduce the risk and severity of recurrence.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Morbitzer KA,Taber DJ,Pilch NA,Meadows HB,Fleming JN,Bratton CF,McGillicuddy JW,Baliga PK,Chavin KD

doi

10.1111/ctr.12391

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

862-8

issue

8

eissn

0902-0063

issn

1399-0012

journal_volume

28

pub_type

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