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Progression of Insulin Resistance after Liver Transplantation – Prospective Study

I. Mikova1, D. Erhartova1, K. Dvorakova1, P. Sedivy2, M. Drobny2, M. Dezortova2, M. Hajek2, M. Cahová3, H. Dankova3, E. Sticova4, V. Lanska5, P. Trunecka1

1Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic, 2Radiodiagnostic and Interventional Radiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic, 3Experimental Medicine Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic, 4Department of Clinical and Transplant Pathology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic, 5Medical Statistics Unit, Institute for Clinical and Experimental Medicine, Prague, Czech Republic

Meeting: 2020 American Transplant Congress

Abstract number: B-169

Keywords: Hyperglycemia, Liver transplantation, Magnetic resonance imaging, Metabolic disease

Session Information

Session Name: Poster Session B: Liver: Recipient Selection

Session Type: Poster Session

Date: Saturday, May 30, 2020

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

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Insulin resistance (IR) plays an important role in pathogenesis of nonalcoholic fatty liver disease (NAFLD) and other diseases. The data about prevalence and evolution of IR in patients before and after liver transplantation (LTx) are limited. The aim of our prospective study was to evaluate the prevalence and evolution of IR in patients before and in the first two years after LTx.

*Methods: In 77 patients listed for LTx in period from May 2015 to April 2017, clinical, laboratory and elastographic evaluation was performed before LTx, 6 months (6M), 1 year (1Y) and 2 years (2Y) after LTx. Liver fat content using 1H MR spectroscopy was also determined. Liver graft biopsy was performed 1 and 2 years after LTx.

*Results: IR defined as HOMA-IR ≥ 3,0 was found in 26 patients (41.3 %) before LTx, 16 patients (25.4 %) at 6M after LTx, 22 patients (34.9 %) at 1Y after LTx and 29 patients (46.0 %) at 2Y after (p=0.028 for 2Y vs 6M). The pretransplant IR correlated with age, indication for LTx and the presence of metabolic syndrome. IR at 2Y after LTx correlated with the presence of metabolic syndrome, hypertension, diabetes mellitus, BMI, GGT, with the liver fat content estimated both histologically and by 1H MR spectroscopy, with grade of ballooning in liver biopsy and with fibrosis stage estimated by shear wave elastography.

*Conclusions: The prevalence of IR is high in patients both before and after LT and it increases significantly with time after LTx. Post-transplant IR as partly modifiable risk factor should get attention in clinical practice.

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To cite this abstract in AMA style:

Mikova I, Erhartova D, Dvorakova K, Sedivy P, Drobny M, Dezortova M, Hajek M, Cahová M, Dankova H, Sticova E, Lanska V, Trunecka P. Progression of Insulin Resistance after Liver Transplantation – Prospective Study [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/progression-of-insulin-resistance-after-liver-transplantation-prospective-study/. Accessed June 6, 2025.

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