Kishi Y, Sugawara Y, Tamura S, Kaneko J, Matsui Y, Makuuchi M
Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Transplant Proc. 2006 Nov;38(9):2989-92. doi: 10.1016/j.transproceed.2006.08.112.
The relationship between hepatitis C virus (HCV) infection and new-onset diabetes mellitus (NODM) after liver transplantation is a controversial issue.
A total of 223 adult living donor liver transplantation (LDLT) recipients followed for more than 6 months were analyzed for the prevalence of NODM. The prevalence was compared between 62 HCV-positive and 161 HCV-negative patients. All the HCV-positive patients underwent preemptive antiviral treatment with interferon alpha2b and ribavirin.
Preoperative diabetes mellitus was more frequently observed in HCV-positive patients (18% vs 4%, P = .001). NODM occurred more frequently in HCV-positive patients (41% vs 22%, P = .003). Multivariate analysis, however, revealed that HCV was not a predictor for NODM. A comparison of 14 HCV-positive patients with persistent NODM and 48 patients without persistent NODM indicated that there was no significant difference in the frequency of the viral response to antiviral therapy nor in HCV-RNA levels. Impaired glucose tolerance did not impact postoperative survival after LDLT.
HCV was not associated with the prevalence of NODM after LDLT. NODM did not influence patient survival.
肝移植后丙型肝炎病毒（HCV）感染与新发糖尿病（NODM）之间的关系是一个有争议的问题。
对223例随访时间超过6个月的成人活体肝移植（LDLT）受者进行分析，以确定NODM的患病率。比较了62例HCV阳性患者和161例HCV阴性患者的患病率。所有HCV阳性患者均接受了干扰素α2b和利巴韦林的预防性抗病毒治疗。
HCV阳性患者术前糖尿病的发生率更高（18%对4%，P = .001）。HCV阳性患者中NODM的发生率更高（41%对22%，P = .003）。然而，多变量分析显示HCV不是NODM的预测因素。对14例持续发生NODM的HCV阳性患者和48例未持续发生NODM的患者进行比较，结果表明抗病毒治疗的病毒反应频率和HCV-RNA水平均无显著差异。糖耐量受损对LDLT术后生存无影响。
HCV与LDLT后NODM的患病率无关。NODM不影响患者生存。
