Diaphragmatic weakness, injury, and atrophy occur rapidly in critically ill patients during MV, and are significantly correlated with the duration of ventilator support.

Excessive alcohol consumption has a negative impact on long-term survival after liver transplant, irrespective of the primary indication. Death is mainly due to recurrence of liver disease and non-hepatic cancer.

The type of arterial reconstruction used for arterial anastomosis during primary liver transplantation has an impact on the occurrence of early HAT. The use of a long graft artery is an independent risk factor of early HAT. Thereby, we recommend the use of a short graft artery with a direct path when feasible to reduce the occurrence of early HAT after primary liver transplantation.

Key Points 1. Despite methodological problems in estimating the true incidence of new-onset diabetes (NODM), it is generally accepted that this is a common complication of liver transplantation (LT), with the mean reported incidence varying between 7% and 30%. 2. The main predictors of post-LT NODM are ethnicity, a family history of diabetes, age Ͼ 45 years, glucose intolerance prior to LT, central obesity, metabolic syndrome, use of corticosteroids over a long period, use of tacrolimus, and hepatitis C infection. 3. NODM is associated with impaired long-term graft function and reduced survival. Diabetes is among the main risk factors for coronary heart disease, cerebrovascular disease, and peripheral occlusive arterial disease in transplant recipients. 4. The management of NODM includes the therapeutic and preventive steps taken in patients with type 2 diabetes. Little information exists on the use of antidiabetic compounds in transplant recipients. Some studies have suggested that LT recipients with NODM may benefit from a conversion to cyclosporine through improved glucose metabolism. Liver Transpl 15: S79-S82, 2009. © 2009 AASLD.As operative techniques and immunosuppressive management have improved, long-term survival after liver transplantation (LT) has increased, with 5-and 10-year patient survival of 70% and 60%, respectively. The main threats to the graft are currently those associated with rejection episodes, biliary and vascular complications, and recurrence of the initial liver disease, particularly hepatitis C and hepatocellular carcinoma. However, the longer survival of LT recipients has emphasized the need to consider other complications that develop several years after LT: chronic renal dysfunction, metabolic complications (diabetes mellitus, dyslipidemia, obesity, and arterial hypertension), and cancers. The chronic adverse effects of immunosuppressive drugs, pretransplant disorders, and lifestyle all contribute to those complications.Despite methodological problems in estimating the true incidence of new-onset diabetes (NODM), it is generally admitted that this is a common complication after LT.1 The development of NODM remains one of the major challenges for reducing premature deaths in LT recipients. The condition is associated with an increase in cardiovascular morbidity and mortality, impaired graft survival and function, more infections, and overall reductions in the quality of life and survival of patients.1-3 The natural history of NODM shares many similarities with that of type 2 diabetes. This provides a rationale for using data on the epidemiology and management of type 2 diabetes to develop a practical management strategy for patients with posttransplant diabetes.