New onset diabetes after transplantation (NODAT) occurs less frequently in living donor liver transplant (LDLT) recipients than in deceased donor liver transplant (DDLT) recipients. The aim of this study was to compare the incidence and predictive factors for NODAT in LDLT versus DDLT recipients. The Organ Procurement and Transplant Network/United Network for Organ Sharing database was reviewed from 2004 to 2010, and 902 LDLT and 19,582 DDLT nondiabetic recipients were included. The overall incidence of NODAT was 12.2% at 1 year after liver transplantation. At 1, 3, and 5 years after transplant, the incidence of NODAT in LDLT recipients was 7.4, 2.1, and 2.6%, respectively, compared to 12.5, 3.4, and 1.9%, respectively, in DDLT recipients. LDLT recipients have a lower risk of NODAT compared to DDLT recipients (hazard ratio = 0.63 (0.52–0.75), ). Predictors for NODAT in LDLT recipients were hepatitis C (HCV) and treated acute cellular rejection (ACR). Risk factors in DDLT recipients were recipient male gender, recipient age, body mass index, donor age, donor diabetes, HCV, and treated ACR. LDLT recipients have a lower incidence and fewer risk factors for NODAT compared to DDLT recipients. Early identification of risk factors will assist timely clinical interventions to prevent NODAT complications. 1. Introduction New onset diabetes mellitus after transplantation (NODAT) is a serious metabolic complication with a reported incidence of 10% to 36% in liver transplant recipients [1–8]. The variation in the incidence of NODAT is due to differences in the diagnostic criteria for NODAT, patient characteristics,duration of the study period, and variation of immunosuppressive regimens used. Studies suggest that NODAT in liver transplant recipients is associated with a significant increase in cardiovascular disease, infection, and decreased graft survival [6–10]. Multiple risk factors are known to be associated with NODAT [1–6, 11, 12]. Age, male gender, body mass index (BMI), hepatitis C virus infection (HCV), impaired fasting glucose, immunosuppressive medications, and acute cellular rejection (ACR) episodes are documented as predictive factors for NODAT. The existing literature focuses on the prevalence and risk factors for NODAT in deceased donor liver transplant (DDLT) recipients [1–6]. However, the incidence and predictors of NODAT in living donor liver transplant (LDLT) recipients are not well established. In a single center retrospective study of 84 Chinese LDLT recipients, the incidence of NODAT was 14.9% [13]. The only risk factor identified was body
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