45 New-onset diabetes after transplant (NODAT): incidence, risk analysis and impact on survival

Abstract

Background Orthotopic liver transplant has become the standard of care for end-stage liver disease and hepatocellular cancer. Better immunosuppressant paved way for improved survival rates post-transplant. But with this longevity comes a higher prevalence of chronic diseases such as New Onset Diabetes After Transplant (NODAT), Hypertension, metabolic syndrome etc. which have a negative impact on graft function and patient survival. Aim To study the incidence of NODAT, factors predictive of NODAT and impact of NODAT on mortality and post-transplant survival. Method It was a retrospective cohort study of 283 living donor liver transplant recipients from 29/4/2011 till 26/4/2016. Data was collected from records. Simple means and standard deviation was calculated for continuous variables while frequency statistics were calculated for categorical ones. Risk factors were assessed using binary logistic regression analysis. Results A total of 130 post liver transplant patients were analysed after exclusion. NODAT was present in 41/130 (31.5%) patients, while 19/130 (14.6%) patients had impaired fasting glycaemia. Acute cellular rejection and Post-transplant Hyperglycemia showed increased odds of acquiring NODAT post-transplant. NODAT had significant association with mortality and decreased survival (p=0.05). Conclusions This cohort showed that NODAT is an important post-transplant entity with significant impact on mortality and survival. Early identification of at-risk patients is suggested.