New-Onset Diabetes after Adult Liver Transplantation in the Korean Organ Transplantation Registry Study

J. Kim¹, S. Hwang², K. Lee³, J. Lee⁴, J. Ryu⁵, B. Kim⁶, D. Choi⁷, Y. You⁸, D. Kim⁹, Y. Nah¹⁰, K. Kang¹¹, M. Kim⁴

¹Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of, ²Department of Surgery, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Korea, Republic of, ³Department of Surgery, Seoul National University College of Medicine, Seoul, Korea, Republic of, ⁴Department of Surgery, Yonsei University College of Medicine, Seoul, Korea, Republic of, ⁵Department of Surgery, Pusan National University College of Medicine, Busan, Korea, Republic of, ⁶Department of Liver Transplantation and Hepatobiliary Surgery, Ajou University School of Medicine, Suwon, Korea, Republic of, ⁷Department of Surgery, Catholic University of Daegu College of Medicine, Daegu, Korea, Republic of, ⁸Department of Surgery, College of Medicine, Catholic University of Korea, Seoul, Korea, Republic of, ⁹Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea, Republic of, ¹⁰Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea, Republic of, ¹¹Department of Surgery, Keimyung University School of Medicine, Daegu, Korea, Republic of

Meeting: 2020 American Transplant Congress

Abstract number: C-141

Keywords: Hyperglycemia, Immunosuppression, Living donor, Outcome

Session Information

Session Name: Poster Session C: Liver Retransplantation and Other Complications

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: New-onset diabetes after transplantation (NODAT) is a serious complication following liver transplantation (LT). The present study aimed to investigate the incidence of and risk factors for NODAT using the Korean Organ Transplantation Registry (KOTRY) database.

*Methods: Patients with history of pediatric transplantation (age ≤18 years), re-transplantation, multi-organ transplantation, or pre-existing diabetes mellitus were excluded. A total of 1,919 non-diabetic adult patients who underwent a primary LT between May 2014 and December 2017 were included. Risk factors were identified using Cox regression analysis.

*Results: NODAT occurred in 19.7% (n=377) of adult liver transplant recipients. Multivariate analysis showed steroid use, increased age, and high body mass index (BMI) in recipients, and implantation of a left-side liver graft was closely associated with NODAT in adult liver transplantation. In living donor liver transplant (LDLT) patients (n=1,473), open donor hepatectomy in the living donors, steroid use, small for size liver graft (graft to recipient weight ratio ≤0.8), increased age, and high BMI in the recipient were predictive factors for NODAT. The use of antimetabolite and basiliximab induction reduced the incidence of NODAT in adult LT and in adult LDLT.

*Conclusions: Basiliximab induction, early steroid withdrawal, and antimetabolite therapy may prevent NODAT after adult liver transplantation. High BMI or advanced age in liver recipients, open donor hepatectomy in living donors, and small size liver graft can predict the occurrence of NODAT after adult LT or LDLT.

To cite this abstract in AMA style:

Kim J, Hwang S, Lee K, Lee J, Ryu J, Kim B, Choi D, You Y, Kim D, Nah Y, Kang K, Kim M. New-Onset Diabetes after Adult Liver Transplantation in the Korean Organ Transplantation Registry Study [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/new-onset-diabetes-after-adult-liver-transplantation-in-the-korean-organ-transplantation-registry-study/. Accessed May 11, 2025.

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