- 143159University Health System, San Antonio, TX, USA.
- 2University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- 3University of Texas at Austin College of Pharmacy, Austin, TX, USA.
- 4130378University of the Incarnate Word Feik School of Pharmacy, San Antonio, TX, USA.
- 514742University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- 6Arizona Liver Health, Chandler, AZ, USA.
Introduction: Posttransplant diabetes mellitus (PTDM) can increase morbidity and mortality in liver transplant recipients. Although hepatitis C seropositivity is a known risk factor for PTDM, the impact of viremia versus no viremia at time of transplant is unknown.
Project aims: This program evaluation sought to compare PTDM in hepatitis C seropositive patients with and without viremia at the time of liver transplant.
Design: This single-center retrospective review included adult hepatitis C seropositive liver transplant recipients transplanted between January 1, 2010 to September 5, 2017 without pretransplant diabetes. Primary outcome was PTDM within 1 year. Secondary outcomes included evaluating 1-year posttransplant death-censored graft loss, mortality, and metabolic outcomes.
Results: Fifty-seven liver transplant recipients with hepatitis C were included, of which 53% (n = 30) were viremic at transplant. Baseline characteristics were similar between groups. Significantly more patients with pretransplant viremia developed PTDM by 1-year posttransplant compared to the patients without viremia (43% vs 11%, P = 0.01). There were no differences between groups outside of more patients with viremia requiring antihypertensives by 1-year posttransplant compared to patients without viremia (57% vs 22%, P = 0.01).
Conclusion: Liver transplant patients with hepatitis C viremia at transplant were more likely to develop PTDM at 1 year compared to those without pretransplant viremia. This is an added consideration when deciding the timing of direct-acting antiviral (DAA) utilization in the context of liver transplant for hepatitis C seropositive patients.