Impact of immunosuppressant therapy on new-onset diabetes in liver transplant recipients

Fu Chao Liu, Huan Tang Lin, Jr Rung Lin, Huang Ping Yu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

5 Scopus citations


This nationwide, population-based study aimed to clarify the effects of immunosuppressive regimens on new-onset diabetes after liver transplantation (NODALT). The National Health Insurance database of Taiwan was explored for patients who received liver transplantation without pre-transplant diabetes from 1998 to 2012. Information regarding clinical conditions and immunosuppressant utilization among these patients was analyzed statistically. Of the 2,140 patients included in our study, 189 (8.8%) developed NODALT. The pre-transplant risk factors for NODALT were identified as old age, male sex, hepatitis C, alcoholic hepatitis, and immunosuppressant use of tacrolimus (TAC). All patients used corti-costeroids as a baseline immunosuppressant. The immunosuppressant regimen of cyclosporine (CsA)+TAC+mycophenolate mofetil (MMF) contributed most to NODALT (adjusted hazard ratio 7.596) in comparison with the regimens of TAC+MMF and CsA+MMF; this regimen also contributed significantly to higher post-transplant bacteremia, urinary tract infection, pneumonia, renal failure, and mortality rate. In conclusion, our analysis confirmed TAC-based immunosuppression contributes to higher NODALT incidence than CsA-based regimen, and TAC-CsA conversion due to any causes might lead to worse clinical outcomes. Clinicians should make better risk stratifications before prescribing immunosuppressants for liver transplant recipients.

Original languageEnglish
Pages (from-to)1043-1051
Number of pages9
JournalTherapeutics and Clinical Risk Management
StatePublished - 18 08 2017

Bibliographical note

Publisher Copyright:
© 2017 Liu et al.


  • Clinical outcome
  • Immunosuppressant
  • Liver transplantation
  • New-onset diabetes
  • Population-based study


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