To study the clinical feature and management of post-transplant diabetes mellitus(PTDM) following orthotopic liver transplantation (OLT).

The clinical data of 58 patients of PTDM in our transplant center from October 2003 to Auguest 2008 were retrospectively analyzed. The dose of steroid was decreased or withdrawn in 15 of 23 patients who used steroid as one of the immunosuppressants(the group of steroid). Sixteen patients of PTDM who used FK506 as the only immunosuppressant were conversed to MMF or sirolimus-based immunosuppression protocol(the group of FK506). The prognosis of these patients after three months were analyzed to study the relationship between the immunosuppressant and PTDM.

Fifty-two(89.7%) patients had not the diabetic symptoms and 41(70.7%) patients were treated with insulin. In the group of steroid, 5 patients had antidiabetic measures withdrawn and the diabetes mellitus had been reversed. Eleven patients had insulin decreased dramatically or withdrawn. No one had acute rejection in this group. In the group of FK506, 2 patients had diabetes mellitus reversed. Ten patients had insulin decreased dramatically or withdrawn. One patient had acute rejection in this group and the rejection had been controlled after the dose of FK506 was increased.

Patients of PTDM following OLT are often asymptomatic and most of them need insulin treatment. Both of reducing the dose of steroid and FK506 and conversion to MMF or sirolimus-based immunosuppression protocol have a significant influence of PTDM.