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Grottenthaler, J.M.* ; Füger, J.K.* ; Mahling, M. ; Königsrainer, A.* ; Malek, N.P.* ; Birkenfeld, A.L. ; Nadalin, S.* ; Berg, C.P.* ; Heyne, N. ; Guthoff, M.

Dynamics of glucose metabolism after liver transplantation: Prediabetes as a window of opportunity for patient survival and long-term kidney function.

Transpl. Int. 34, 1959-1970 (2021)
Publ. Version/Full Text Postprint DOI PMC
Open Access Gold (Paid Option)
Creative Commons Lizenzvertrag
Posttransplantation diabetes mellitus (PTDM) is a relevant complication following liver transplantation with profound impact on morbidity and mortality. To date, little is known about the evolution and dynamics of glucose metabolism and the impact of prediabetes in long-term follow-up. To address this issue, all consecutive adult liver transplant recipients (n=429) from a European university hospital transplant center between 2007 and 2017 were analyzed retrospectively. In patients without pre-existing diabetes (n=327), we conducted a longitudinal characterization of glucose metabolism. Median follow-up was 37 [9-64, IQR] months. Median prevalence of prediabetes was 39 [37-39]% and of PTDM 21 [17-22]%. Throughout follow-up, intra-individual glucose regulation of patients was highly variable, continuously fluctuating between different states of glucose metabolism (normal glucose tolerance, prediabetes, PTDM). Whereas overall survival and long-term kidney function of patients with PTDM were significantly lower than that of patients with normal glucose metabolism, prediabetes was not associated with adverse outcome. This study provides new insight into the dynamics and impact of glucose metabolism after liver transplantation. Unlike PTDM, prediabetes is not associated with adverse outcome, providing a window of opportunity for targeted intervention. The results underline the need for constant screening and intervention in post-transplant care of liver allograft recipients.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Dynamics ; Kidney Function ; Liver Transplantation ; Mortality ; Outcome ; Posttransplantation Diabetes Mellitus ; Prediabetes; Posttransplant Diabetes-mellitus; Impaired Fasting Glucose; Stage Renal-disease; Impact; Cyclosporine; Tacrolimus; Recipients; Risk
ISSN (print) / ISBN 0934-0874
e-ISSN 1432-2277
Journal Transplant international
Quellenangaben Volume: 34, Issue: 10, Pages: 1959-1970 Article Number: , Supplement: ,
Publisher Wiley
Publishing Place Oxford
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)