Combined liver and islet transplantation in hepatogenous diabetes, cluster exenteration, and cirrhosis with type 1 diabetes

Infante, Marco; Padilla, Nathalia; Madiraju, Sri Gita; Álvarez, Ana María Arias; Baidal, David; Ricordi, Camillo; Alejandro, Rodolfo

doi:10.1016/b978-0-12-814833-4.00037-x

Cited by 1 publication

(1 citation statement)

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“…Not only does it increases the incidence of cardiovascular events[ 83 ], but the presence of post-transplant metabolic syndrome may also contribute to the development of new-onset NAFLD after transplantation for non-NAFLD cirrhosis[ 84 ]. While there have been case reports of combined liver and islet transplantation in cirrhotic patients with concurrent type 1 DM[ 85 ], the safety and utility of this technique in patients with hepatogenic diabetes or T2DM is yet to be determined[ 86 ].…”

Section: Diabetes and Liver Transplantationmentioning

confidence: 99%

Clinical implications, diagnosis, and management of diabetes in patients with chronic liver diseases

Chung

Promrat

Wands

2020

WJH

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Diabetes mellitus (DM) negatively affects the development and progression of chronic liver diseases (CLD) of various etiologies. Concurrent DM and CLD are also associated with worse clinical outcomes with respect to mortality, the occurrence of hepatic decompensation, and the development of hepatocellular carcinoma (HCC). Unfortunately, early diagnosis and optimal treatment of DM can be challenging, due to the lack of established clinical guidelines as well as the medical complexity of this patient population. We conducted an exploratory review of relevant literature to provide an up-to-date review for internists and hepatologists caring for this patient population. We reviewed the epidemiological and pathophysiological associations between DM and CLD, the impact of insulin resistance on the progression and manifestations of CLD, the pathogenesis of hepatogenic diabetes, as well as the practical challenges in diagnosis and monitoring of DM in this patient population. We also reviewed the latest clinical evidence on various pharmacological antihyperglycemic therapies with an emphasis on liver disease-related clinical outcomes. Finally, we proposed an algorithm for managing DM in patients with CLD and discussed the clinical and research questions that remain to be addressed.

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