Liver transplantation in cirrhotic patients with diabetes mellitus: Midterm results, survival, and adverse events

Liver cirrhosis is frequently associated with diabetes mellitus (DM), and t his metabolic complication is also frequent after orthotopic liver transpla ntation (OLT). The aim of our study is to investigate which factors are ass ociated with DM before and after OLT and their impact on post-OLT evolution . We evaluated the prevalence of DM among 115 liver transplant candidates w ith cirrhosis and assessed their evolution after OLT (median follow-up, 41 months). Sixteen candidates had DM requiring pharmacological therapy (group A), 45 candidates had DM controlled with diet (group B), and 54 candidates did not have DM (group C). One-year and 3-year actuarial survival rates we re 100% and 100% for group A, 91% and 85% for group B, and 77% and 74% for group C, respectively (P<.03). Post-OLT DM was more frequent in group A. Th e incidence of other metabolic complications, major infections, rejection, and arterial hypertension; the need for hospitalization; and renal and graf t function of patients in groups A, B, and C were similar. The only risk fa ctor for DM 1 year after OLT on multivariate analysis was pre-OLT DM requir ing pharmacological treatment. The incidence of complications, need for hos pitalization, and renal and graft function I year after OLT for patients wi th post-OLT DM were similar to those of patients without post-OLT DM. In co nclusion, patients with cirrhosis who have DM have a greater risk for post- OLT DM, but their midterm survival is not worse than the survival of those without DM.