Relationship Between Hepatitis C Virus Recurrence and De Novo Diabetes After Liver Transplantation: The Hungarian Experience

Gelley, Fanni; Zádori, Gergely; Firneisz, Gábor; Wagner, László; Fehérvári, Imre; Gerlei, Zsuzsanna; Fazakas, János; Pápai, Simon; Lengyel, Gabriella; Sárváry, Enikő; Nemes, Balázs

doi:10.1016/j.transproceed.2011.03.065

Cited by 10 publications

(4 citation statements)

References 12 publications

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“…The retrospective subgroup analysis by Wallia et al[ 19 ] found that the patients in the non-GMS group with higher BG levels exhibited higher rate of infection compared to the patients in the GMS group at one-year post-LT follow up (79% vs 51% respectively, P = 0.015). Gelley at al [ 21 ] found that higher early postoperative fasting plasma glucose led to higher incidence of HCV recurrence (diagnosed with histology criteria of the Knodell score), although no data was shown with regards to BG levels.…”

Section: Resultsmentioning

confidence: 99%

Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review

Paka

Lieber

Lee

et al. 2018

WJT

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AIMTo investigate the relationship between post-liver transplantation (LT) glycemic control and LT outcomes.METHODSA qualitative systematic review on relevant prospective interventions designed to control glucose levels including insulin protocols. Studies investigating an association between glycemic control and post-LT outcomes such as mortality, graft rejection, and infection rate were reviewed. PubMed, EMBASE, and other databases were searched through October 2016.RESULTSThree thousands, six hundreds and ninety-two patients from 14 studies were included. Higher mortality rate was seen when blood glucose (BG) ≥ 150 mg/dL (P = 0.05). BG ≥ 150 mg/dL also led to higher rates of infection. Higher rates of graft rejection were seen at BG > 200 mg/dL (P < 0.001). Mean BG ≥ 200 mg/dL was associated with more infections (P = 0.002). Nurse-initiated protocols and early screening strategies have shown a reduction in negative post-LT outcomes.CONCLUSIONHyperglycemia in the perioperative period is associated with poor post-LT outcomes. Only a few prospective studies have designed interventions aimed at managing post-LT hyperglycemia, post-transplant diabetes mellitus (PTDM) and their impact on post-LT outcomes.

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Section: Resultsmentioning

confidence: 99%

Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review

Paka

Lieber

Lee

et al. 2018

WJT

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“…Several studies have shown that in comparison with patients undergoing transplantation for other conditions, HCV‐positive patients have an increased risk (2‐4 times) of developing type 2 diabetes mellitus after transplantation 20‐24. One recent study has suggested that early recurrent viral infection is particularly associated with the development of diabetes 25. As in the native liver, the presence of diabetes mellitus has been identified as an independent risk factor for rapid progression to advanced fibrosis in HCV‐positive individuals 22, 23, 26‐28…”

Section: Risk Factors Associated With Rapidly Progressive Hcv Infectimentioning

confidence: 99%

Steatosis and fibrosis progression in patients with recurrent hepatitis C infection: Complex interactions providing diagnostic and therapeutic challenges

Hübscher¹

2011

Liver Transpl

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The relationship between hepatitis C virus (HCV) infection and hepatic steatosis is complex and involves a number of interrelated mechanisms that regulate viral replication, insulin resistance (IR), and lipid metabolism in the liver. The situation becomes even more complex in HCV-positive patients undergoing liver transplantation, largely because of the effects of immunosuppression. In this issue of Liver Transplantation, Brandman et al. 1 from the University of California San Francisco report an investigation of a number of the components of this complex and multifactorial relationship.In the nontransplant setting, HCV infection is recognized as an important risk factor for IR and hepatic steatosis. The prevalence of type 2 diabetes mellitus, an important result of severe IR, is significantly greater in patients with chronic HCV infection (20%-50%) than in those with other chronic liver diseases (approximately 10%). 2 Likewise, steatosis is seen in 40% to 86% of liver biopsy samples from patients with chronic HCV infection, 3 and this rate is considerably higher than the frequency observed in patients with other chronic liver diseases or in the general population. The development of hepatic steatosis can be viewed as a mechanism that promotes viral replication: the HCV core protein is targeted to lipid droplets, which act as intracellular storage organelles and are also required for virus assembly. 4 Two main pathways for HCV-induced hepatic steatosis have been proposed: metabolic and viral. The first involves a number of HCV-mediated mechanisms that result in IR and is seen in individuals infected with a non-3 genotype (particularly genotype 1). 3,5 The factors involved in the pathogenesis of HCVinduced IR are complex and include (1) direct effects on insulin signaling pathways, (2) altered glucose uptake by hepatocytes, and (3) the production of proinflammatory cytokines such as tumor necrosis factor a and reactive oxygen species (both appear to promote IR through mechanisms that are incompletely understood). 2,6,7 HCV infections also appear to promote truncal obesity, which is an important mechanism in the development of hepatic steatosis and inflammation. 8 In this setting, the severity of steatosis correlates with risk factors for metabolic syndrome rather than viral RNA levels. In contrast, in genotype 3-infected individuals, there is a direct correlation between the HCV RNA levels and the severity of steatosis, which diminishes in patients who achieve a sustained virological response to antiviral therapy; this suggests a direct effect of the virus on lipid metabolism. 3,5 The pathogenesis of viral-induced steatosis likely involves a number of effects of HCV on lipid metabolism in hepatocytes; these include increased lipid production by the up-regulation of Abbreviations: HCV, hepatitis C virus; IR, insulin resistance.

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“…However, very few studies have investigated whether this association of IR/DM and HCV continues post‐liver transplantation (LT) in HCV‐positive patients . Current evidence suggests that there is an increased risk of development post‐transplant DM in patients with HCV, especially in patients who had IR/DM prior to transplantation: more than 50% of such patients develop diabetes post‐transplantation . However, questions still persist as to how strong this relationship is and also whether the extent of this association is influenced by diabetogenic immunosuppressive drugs such as tacrolimus.…”

Section: Introductionmentioning

confidence: 99%

The association of hepatitis C virus infection and post‐liver transplant diabetes: data from 17 000 HCV‐infected transplant recipients

Younossi

Stepanova

Saab

et al. 2014

Aliment Pharmacol Ther

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Relationship Between Hepatitis C Virus Recurrence and De Novo Diabetes After Liver Transplantation: The Hungarian Experience

Cited by 10 publications

References 12 publications

Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review

Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review

Steatosis and fibrosis progression in patients with recurrent hepatitis C infection: Complex interactions providing diagnostic and therapeutic challenges

The association of hepatitis C virus infection and post‐liver transplant diabetes: data from 17 000 HCV‐infected transplant recipients

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