Long-term post-liver transplant complications of renal impairment and diabetes mellitus: data from Singapore

Singapore Med J. 2006 Jul;47(7):604-8.

Abstract

Introduction: Patients who survive the initial post-liver transplantation period face the development of chronic diseases in the long run. We studied two important complications of liver transplantation, namely: renal impairment and diabetes mellitus.

Methods: We analysed adult patients followed-up for more than one year using data from our liver transplant clinical records. Long-term post-transplant renal impairment (RI) was defined as glomerular filtration rate (GFR) less than 60 ml/min/1.73 square metres and long-term post-transplant diabetes mellitus (DM) was defined as fasting blood glucose more than 7.8 mmol/L, that existed at least one year after liver transplantation. Pre- and post-transplant factors that could be associated with these conditions were examined.

Results: Altogether, 35 patients were evaluated. Mean age at transplant was 50 years. Mean duration of follow-up was 58.4 months. There was 11.4 percent of pre-transplant RI and 17.0 percent of pre-transplant DM. Prevalence of post-transplant RI was 43.5 percent at one year and 45.0 percent at four years. Long-term post-transplant RI was associated with renal impairment at six months post-transplant (p-value is 0.033). Prevalence of severe post-transplant RI (GFR is less than 30 ml/min/1.73 square metres) at four years was 5.7 percent. Prevalence of post-transplant DM was 45.5 percent at two years but declined to 5.3 percent at four years.

Conclusion: Post-transplant renal impairment appears to be a potential long-term problem while post-transplant diabetes mellitus appears to improve with time.

MeSH terms

  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / statistics & numerical data
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / etiology*
  • Singapore / epidemiology