Post-transplant Diabetes Mellitus In HBV Related Recipients

Background:As we all know,there were a lot of persons who were infected hepatitis B virus (HBV) in China.HBV is an important factor that causes liver cirrhosis.The patients who have liver disease especially end-stage liver disease always go with diabetes mellitus(DM).We want to know how serious the DM after liver transplantation.Methods:There were 304 recipients undergoing cadaveric related liver transplantation.The recipients who had no HBV infected,death in 3months,acute rejection were excluded. There were 165 recipients met the terms.All the 165 recipients are divided into two groups,Post-transplant diabetes mellitus(PTDM),or non-PTDM.Results:There were 28 recipients suffered DM before liver transplantation(LT).Of the 28 patients,10 patients also suffered DM after transplantation.DM before LT doesn't impact the prognosis.Forty(24.24%) recipients suffered PTDM with a mean time of 36 days(from2 days to 10 months) after LT.Twenty-nine(72.50%) recipients who suffered PTDM needed insulin to control blood sugar.The hepatic encephalopathy before LT was more common in PTDM group than in non-PTDM group.The tacrolimus were more application in PTDM group than in non-PTDM group.The plasma tacrolimus concentration in 1 month,3 month were higher in PTDM group than in non-PTDM group.Also in the recipients who received LT for hepatic cell carcinoma, we found poorer survival in the PTDM group.The complications after liver transplantation including sepsis,fungus infection,chronic kidney diseases and biliary complications were more in the PTDM group than in non-PTDM group.Conclusion:1.DM before LT doesn't impact the prognosis.2.PTDM cause poor outcome in recipients who received LT for hepatic cell carcinoma.3.Hepatic encephalopathy before LT,tacrolimus based regiment and high concentration of tacrolimus are the risk factors for PTDM.