Renal impairment and diabetes mellitus after liver transplant

One of the major concerns in liver transplant patients who survive past 1 year posttransplant is the development of chronic diseases. We studied two important clinical conditions that can have a chronic course—renal impairment and diabetes mellitus—among long-term liver transplant survivors. All adult patients transplanted and followed for at least 1 year were evaluated for clinical status, blood tests, and imaging studies. The occurrence and development of renal impairment, defined as a serum creatinine above 125 μmol/L or creatinine clearance less than 75 mL/min, or diabetes mellitus were evaluated for contributing factors. The 35 evaluated patients of mean age at transplant of 50 years had a mean follow-up duration of 45 months. The incidence of posttransplant renal impairment was 22.8% at 1 year and 47.6% at 3 years. This disorder was associated with pretransplant renal impairment and with a diagnosis of diabetes. Posttransplant diabetes mellitus was observed in 48.6% with 41.1% resolving over time. Posttransplant renal impairment appears to be a potential long-term problem. Although this relates to pretransplant conditions, longer follow-up is required to examine whether posttransplant factors contribute to its progression.