Comparison of New-onset Diabetes After Transplantation Between Two Steroid Withdrawal Group With CellCept
Status:
Unknown status
Trial end date:
2018-02-01
Target enrollment:
Participant gender:
Summary
With improvements in patient and graft survival, increasing attention has been placed on
complications that contribute to long-term patient morbidity and mortality. New-onset
diabetes after transplantation (NODAT) is a common complication of solid-organ
transplantation, and is a strong predictor of graft failure and cardiovascular mortality in
the transplant population. Risk factors for NODAT in transplant recipients are similar to
those in non-transplant patients, but transplant-specific risk factors such as hepatitis C
(HCV) infection, corticosteroids and calcineurin inhibitors play a dominant role in NODAT
pathogenesis. The predominant factor for causing NODAT by corticosteroids seems to be the
aggravation of insulin resistance; however several studies have displayed deleterious effects
on insulin secretion and β-cells. Thus, adjusting the immunosuppressant regimen to improve
glucose tolerance must be measured and defined from long term perspective.
As recipients of organ transplants survive longer, the complications of NODAT have assumed
greater importance; therefore, we designed a prospective study to compare the safety and
efficacy of early versus late withdrawal of corticosteroids after liver transplantation.