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Posttransplantation diabetes

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https://www.readbyqxmd.com/read/28930756/dynamics-of-glucose-metabolism-after-kidney-transplantation
#1
Martina Guthoff, Robert Wagner, Karoline Weichbrodt, Silvio Nadalin, Alfred Königsrainer, Hans-Ulrich Häring, Andreas Fritsche, Nils Heyne
BACKGROUND/AIMS: Posttransplantation diabetes mellitus (PTDM) impacts patient and allograft survival after kidney transplantation. Prediabetes, which is an independent risk factor for PTDM, is modifiable also in a post-transplant setting. Understanding the risks and dynamics of impaired glucose metabolism after transplantation is a key component for targeted intervention. METHODS: A retrospective chart analysis of all adult non-diabetic renal allograft recipients (n=251, 2007-2014) was performed...
September 20, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28923631/effect-of-prereperfusion-ephedrine-on-postreperfusion-syndrome-and-graft-function-in-living-donor-liver-transplantation
#2
I S Chung, H S Jee, S Han, J S Ko, M S Gwak, S J Choi, G S Kim, S-K Lee
A characteristic pattern of hemodynamic changes that may occur after reperfusion during liver transplantation (LT) is known as postreperfusion syndrome (PRS). We investigated the effect of prophylactic ephedrine administration on PRS and postoperative laboratory results in living donor LT. The medical records of adult recipients who underwent living donor LT were reviewed. A total of 308 recipients were divided into the prophylaxis group and the nonprophylaxis group. Graft factors, preoperative and intraoperative recipient factors, and postoperative laboratory results were compared between the 2 groups...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28894795/liver-enzymes-and-the-development-of-posttransplantation-diabetes-mellitus-in-renal-transplant-recipients
#3
Gerald Klaassen, Eva Corpeleijn, Nicole P E Deetman, Gerjan J Navis, Stephan J L Bakker, Dorien M Zelle
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) is common in renal transplant recipients (RTR), increasing the risk of graft failure, cardiovascular disease, and mortality. Early detection of a high risk for PTDM is warranted. Because liver function and liver fat are involved, we investigated whether serum liver markers are associated with future PTDM in RTR. METHODS: Between 2001 and 2003, 606 RTR with a functioning allograft beyond the first year after transplantation were included of which 500 participants (56% men; age, 50 ± 12 years) were free of diabetes at baseline and had liver enzyme values (1 missing) available...
September 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28834572/multiple-genetic-variants-associated-with-posttransplantation-diabetes-mellitus-in-chinese-han-populations
#4
Jie Chen, Lixin Li, Yunfei An, Junlong Zhang, Yun Liao, Yi Li, Lanlan Wang
OBJECTIVES: Posttransplantation diabetes mellitus (PTDM) is a major complication after solid organ transplantation. This study is to investigate the association of nine genetic variant factors and PTDM in Chinese Han patients. METHODS: HLA-DP (rs3077, rs9277535), HLA-DQ (rs7453920), signal transducer and activator of transcription 4 (STAT4) (rs7574865), IL-28B (rs12979860, rs8099917, and rs12980275), and IL-18 (rs1946518 and rs187238) were investigated in 260 liver transplant recipients (PTDM vs non-PTDM) by high-resolution melting curve analysis...
August 23, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28828306/active-surveillance-for-adverse-events-among-patients-who-underwent-renal-transplantation-a-prospective-observational-study
#5
Padmanabhan Guruprasad, Kamal Kishore, Sandeep Mahajan, Sandeep Aggarwal
AIM: Renal transplantation is the treatment of choice for end-stage renal disease patients. Renal transplant recipients, however, have to be on lifelong therapy with immunosuppressants, which are associated with a number of adverse events (AEs). The safety profile of these immunosuppressants is not clear with respect to the Indian population. This study was conducted to find the frequency and pattern of all AEs experienced by Indian renal transplant recipients during the initial 3 months posttransplantation...
July 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/28480091/duodenal-graft-perforation-after-simultaneous-pancreas-kidney-transplantation
#6
Akihito Sannomiya, Ichiro Nakajima, Yuichi Ogawa, Kotaro Kai, Ichiro Koyama, Shohei Fuchinoue
A 45-year-old woman with type 1 diabetes and chronic renal failure on dialysis underwent simultaneous pancreas-kidney transplantation from a brain dead donor. On postoperative day 15, acute generalized peritonitis was diagnosed and emergency laparotomy was performed. Perforation of the donor duodenum was found, which had apparently resulted from duodenal compression by the tip of the intestinal fistula tube placed for decompression. The perforation was sutured and the intestinal fistula tube was exchanged. Following this, perforation repeatedly recurred at the same site and open repair at laparotomy was required a total of four times...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28423197/diabetic-kidney-transplant-recipients-impaired-infection-control-and-increased-alloreactivity
#7
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: Post-transplantation diabetes mellitus (PTDM) has been associated with inferior patient and allograft outcomes. However, previous studies did not identify differences in infection control and alloreactivity. METHODS: We studied 449 kidney transplant recipients (KTRs) between 2005 and 2013. Fifty (11.1%) KTRs were diagnosed with PTDM and 60 (13.4%) KTRs with pre-existing diabetes. Samples were collected pretransplantation, at +1, +2, +3 months post-transplantation...
April 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/27917074/medical-management-of-metabolic-complications-of-liver-transplant-recipients
#8
Abbey Barnard, Peter Konyn, Sammy Saab
Improved short- and long-term survival of liver transplant recipients has led to increased focus on complications of both the early and late posttransplant periods. A variety of metabolic complications have been observed in the post-orthotopic liver transplant population, including hypertension, hyperlipidemia, obesity, diabetes mellitus, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis. Although only a small proportion of patients experience metabolic complications prior to transplantation, the prevalence of these complications posttransplantation reaches or exceeds that of the general population...
October 2016: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27903445/increased-alloreactivity-and-adverse-outcomes-in-obese-kidney-transplant-recipients-are-limited-to-those-with-diabetes-mellitus
#9
Thomas Schachtner, Maik Stein, Petra Reinke
Previous studies on patient and allograft outcomes of obese kidney transplant recipients (KTRs) remain controversial. To what extent obesity-related comorbidities contribute to adverse outcomes, however, hasn't been addressed. We studied all KTRs from 2005 to 2012. 29 (4%), 317 (48%), 217 (33%), 76 (12%), and 21 KTRs (4%) were identified as underweight, normal-weight, overweight, obese, and morbid obese, respectively. 33 of 97 obese KTRs (34%) had pre-existent diabetes. Samples were collected before transplantation and at +1, +2, +3months posttransplantation...
November 27, 2016: Transplant Immunology
https://www.readbyqxmd.com/read/27826600/a-prospective-study-of-renal-transplant-recipients-a-fall-in-insulin-secretion-underpins-dysglycemia-after-renal-transplantation
#10
David Langsford, Varuni Obeyesekere, Sara Vogrin, Jessie Teng, Richard J MacIsaac, Glenn Ward, Frank Alford, Karen M Dwyer
BACKGROUND: Dysglycemia (encompassing impaired glucose tolerance and diabetes mellitus) arising after renal transplantation is common and confers a significant cardiovascular mortality risk. Nonetheless, the pathophysiology of posttransplant dysglycemia is not well described. The aim of this study was to prospectively and comprehensively assess glucose handling in renal transplant recipients from before to 12 months after transplantation to determine the underpinning pathophysiology. MATERIALS AND METHODS: Intravenous and oral glucose tolerance testing was conducted before and at 3 and 12 months posttransplantation...
November 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27801416/-evaluation-of-markers-for-renal-graft-dysfunction-in-patients-with-type-1-diabetes-mellitus-after-kidney-transplantation-and-simultaneous-pancreas-kidney-transplantation
#11
A M Glazunova, M S Arutyunova, E V Tarasov, L V Nikankina, A V Il'in, M Sh Shamkhalova, M V Shestakova, Ya G Moisyuk
AIM: To study the markers of renal graft dysfunction in patients with type 1 diabetes mellitus (T1DM) after kidney transplantation (KT) and simultaneous pancreas-kidney transplantation (SPKT). SUBJECTS AND METHODS: The investigation enrolled 20 patients after successful SPKT and 41 patients after KT (of them 21 received continuous subcutaneous insulin infusion with an insulin doser; 20 had multiple insulin injections). The periods after KT and SPKT at patient inclusion were 8 (7; 8) and 11 (8; 18) months, respectively...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27642745/-posttransplantation-diabetes-mellitus-in-patients-after-kidney-transplantation-incidence-and-risk-factors
#12
Isabell Jahn, Martin Busch, Undine Ott, Gunter Wolf, Wilgard Battefeld
BACKGROUND: Transplantation (NTX) associated ischemia-reperfusion-mechanisms and the predisposition for insulin resistance are discussed as causes of a posttransplantation diabetes mellitus (PTDM). Furthermore, immunosuppressants can have a damaging effect on insulin secretion. METHODS: 55 metabolically healthy patients with an endstage renal disease (age 52 ± 14 years, body mass index 27 ± 5 kg / m(2), blood pressure 137 ± 15/82 ± 11 mmHg) were included in a prospectively cohort study...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27617254/evaluation-of-postoperative-lymphocele-according-to-amounts-and-symptoms-by-using-3-dimensional-ct-volumetry-in-kidney-transplant-recipients
#13
Heungman Jun, Sung Ho Hwang, Sungyoon Lim, Myung Gyu Kim, Cheol Woong Jung
PURPOSE: To analyze the risk factors for postoperative lymphocele, for predicting and preventing complications. METHODS: We evaluated 92 kidney transplant recipients with multidetector CT (MDCT) at 1-month posttransplantation. From admission and 1-month postoperative records, data including diabetes, dialysis type, immunosuppressant use, steroid pulse therapy, and transplantation side were collected. Lymphocele volume was measured with 3-dimensional reconstructed, nonenhanced MDCT at one month postoperatively...
September 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27569936/pilot-randomized-trial-of-tacrolimus-everolimus-vs-tacrolimus-enteric-coated-mycophenolate-sodium-in-adult-primary-kidney-transplant-recipients-at-a-single-center
#14
RANDOMIZED CONTROLLED TRIAL
G Ciancio, P Tryphonopoulos, J J Gaynor, G Guerra, J Sageshima, D Roth, L Chen, W Kupin, A Mattiazzi, L Tueros, S Flores, L Hanson, R H Powell, P Ruiz, R Vianna, G W Burke
BACKGROUND: Recent studies suggest that the combination of tacrolimus (TAC) and everolimus (EVL) could become a viable option for use as standard maintenance immunosuppression in non-highly sensitized kidney transplant recipients. METHODS: We conducted a single-center, open-label, randomized pilot trial comparing two maintenance immunosuppression regimens in non-highly sensitized, adult, primary kidney transplant recipients: (TAC/EVL, Group A) vs our standard maintenance regimen of TAC plus enteric-coated mycophenolate mofetil (TAC/EC-MPS, Group B)...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27547871/incidence-of-posttransplantation-diabetes-mellitus-in-de-novo-kidney-transplant-recipients-receiving-prolonged-release-tacrolimus-based-immunosuppression-with-2-different-corticosteroid-minimization-strategies-advance-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Georges Mourad, Maciej Glyda, Laetitia Albano, Ondrej Viklický, Pierre Merville, Gunnar Tydén, Michel Mourad, Aleksander Lõhmus, Oliver Witzke, Maarten H L Christiaans, Malcolm W Brown, Nasrullah Undre, Gbenga Kazeem, Dirk R J Kuypers
BACKGROUND: ADVANCE (NCT01304836) was a phase 4, multicenter, prospectively randomized, open-label, 24-week study comparing the incidence of posttransplantation diabetes mellitus (PTDM) with 2 prolonged-release tacrolimus corticosteroid minimization regimens. METHODS: All patients received prolonged-release tacrolimus, basiliximab, mycophenolate mofetil and 1 bolus of intraoperative corticosteroids (0-1000 mg) as per center policy. Patients in arm 1 received tapered corticosteroids, stopped after day 10, whereas patients in arm 2 received no steroids after the intraoperative bolus...
August 2017: Transplantation
https://www.readbyqxmd.com/read/27486667/significant-association-between-toll-like-receptor-gene-polymorphisms-and-posttransplantation-diabetes-mellitus
#16
Jin Sug Kim, Seul Ki Kim, Ji Yoon Park, Yang Gyun Kim, Joo Young Moon, Sang Ho Lee, Chun Gyoo Ihm, Tae Won Lee, Su Kang Kim, Joo-Ho Chung, Sun Woo Kang, Tae Hee Kim, Yeong Hoon Kim, Kyung Hwan Jeong
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) is an important metabolic complication after renal transplantation. Activation of the innate immune system via toll-like receptors (TLRs) is implicated in the pathogenesis of insulin resistance and deficiency. Although links between diabetes, dysregulated innate immune responses, and the TLR signaling pathway have been reported, no study so far has investigated their associations with PTDM. In this study, we ascertained whether single nucleotide polymorphisms (SNPs) in TLRs are associated with PTDM in the Korea population...
2016: Nephron
https://www.readbyqxmd.com/read/27391198/predictive-score-for-posttransplantation-outcomes
#17
Miklos Z Molnar, Danh V Nguyen, Yanjun Chen, Vanessa Ravel, Elani Streja, Mahesh Krishnan, Csaba P Kovesdy, Rajnish Mehrotra, Kamyar Kalantar-Zadeh
BACKGROUND: Most current scoring tools to predict allograft and patient survival upon kidney transplantion are based on variables collected posttransplantation. We developed a novel score to predict posttransplant outcomes using pretransplant information including routine laboratory data available before or at the time of transplantation. METHODS: Linking the 5-year patient data of a large dialysis organization to the Scientific Registry of Transplant Recipients, we identified 15 125 hemodialysis patients who underwent first deceased transplantion...
June 2017: Transplantation
https://www.readbyqxmd.com/read/27362306/associations-between-posttransplantation-diabetes-mellitus-and-renal-graft-survival
#18
Ivar Anders Eide, Thea Anine Strøm Halden, Anders Hartmann, Dag Olav Dahle, Anders Åsberg, Trond Jenssen
BACKGROUND: Previous reports indicate that posttransplantation diabetes mellitus (PTDM) is associated with overall renal graft loss, but not death-censored graft loss. METHODS: In this single-center retrospective cohort study of 2749 adult Norwegian renal transplant recipients, transplanted between 1999 and 2011, we estimated overall and death-censored renal graft loss hazard ratios in patients diagnosed with PTDM, impaired glucose tolerance and diabetes before transplantation, using multivariable Cox proportional hazard regression analysis...
June 2017: Transplantation
https://www.readbyqxmd.com/read/27307759/belatacept-for-the-prophylaxis-of-organ-rejection-in-kidney-transplant-patients-an-evidence-based-review-of-its-place-in-therapy
#19
REVIEW
Karen L Hardinger, Daniel Sunderland, Jennifer A Wiederrich
BACKGROUND: Belatacept is a novel immunosuppressive therapy designed to improve clinical outcomes associated with kidney transplant recipients while minimizing use of calcineurin inhibitors (CNIs). METHODS: We searched for clinical trials related to administration of belatacept to kidney transplant patients compared to various immunosuppression regimens, as well as for studies that utilized data from belatacept trials to validate new surrogate measures. The purpose of this review is to consolidate the published evidence of belatacept's effectiveness and safety in renal transplant recipients to better elucidate its place in clinical practice...
2016: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27306531/il-7-mediated-homeostatic-expansion-of-human-cd4-cd25-foxp3-regulatory-t-cells-after-depletion-with-anti-cd25-monoclonal-antibody
#20
Debora Vignali, Clara-Marie Gürth, Silvia Pellegrini, Valeria Sordi, Federico Sizzano, Lorenzo Piemonti, Paolo Monti
BACKGROUND: The maintenance or expansion of regulatory T (Treg) cells has a fundamental role in the achievement of immunological tolerance after transplantation. Here we aimed to determine mechanisms of human Treg cell depletion and reconstitution after anti-CD25 monoclonal antibody (mAb) treatment. METHODS: Seventeen patients with type 1 diabetes who received pancreatic islet transplantation and anti-CD25 mAb as induction therapy were studied. RESULTS: We observed an almost complete depletion of Treg cells after injection of anti-CD25 mAb...
September 2016: Transplantation
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