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Post-transplantation diabetes

Saurabh Chaudhri, Alice A Thomas, Nasreen Samad, Stanley L Fan
AIM: To determine if patients with failing kidney transplants who opt to have peritoneal dialysis (PD) have poor short-term PD technique survival and increased rates of peritonitis. METHODS: We performed a retrospective analysis comparing 50 consecutive patients starting PD after a failed kidney transplant to 93 incident patients starting PD (matching for age, gender, diabetes causing renal failure, ethnicity and year of starting PD). RESULTS: The mean follow-up period was 26 months...
October 20, 2016: Nephrology
Masayoshi Okumi, Yasuyuki Sato, Kohei Unagami, Toshihito Hirai, Hideki Ishida, Kazunari Tanabe
BACKGROUND: The reasons for improved outcomes associated with preemptive kidney transplantation (PKT) are incompletely understood, and post-transplant complications have been scarcely investigated. METHODS: We evaluated the outcomes of PKT in both unmatched (n = 1060) and propensity score matched cohorts (n = 186) of adults who underwent living kidney transplant between 2000 and 2014. Outcomes were estimated glomerular filtration rate (eGFR), biopsy-proven rejection, cytomegalovirus (CMV) infection, post-transplant diabetes mellitus (PTDM), cardiovascular disease (CVD), graft failure (non-censored for death), and malignancy...
October 19, 2016: Clinical and Experimental Nephrology
Kevin V Chow, Emma M Carrington, Yifan Zhan, Andrew M Lew, Robyn M Sutherland
Islet transplantation can cure type 1 diabetes, but is limited by lack of donor organs and early graft dysfunction, such that many patients require multiple transplants to achieve insulin independence. Monocyte derived dendritic cells (moDCs) arise during inflammation and allograft encounters where they can promote various innate and adaptive immune responses. To determine whether moDCs impair early graft function following allogeneic islet transplantation, we transplanted MHC-mismatched BALB/c (H-2d) islets into diabetic C57BL/6-CCR2...
October 13, 2016: Cell Transplantation
L Vida Perez, J L Montero Alvarez, A Poyato Gonzalez, J Briceño Delgado, G Costan Rodero, E Fraga Rivas, P Barrera Baena, M De la Mata Garcia
BACKGROUND: The development of metabolic syndrome (MS) after liver transplantation (LT) is a major source of mortality derived from cardiovascular events. The aim of the present study was to determine the prevalence and risk factors of MS after LT. METHODS: One-hundred seventy-four consecutive LT patients from January 2004 to June 2010 surviving longer than 1 year after LT were included. Median follow-up after LT was 48 months. Independent predictors of MS were obtained by means of multivariate logistic regression...
September 2016: Transplantation Proceedings
L V Kroth, F F Barreiro, D Saitovitch, M A Traesel, D O d'Avila, C E Poli-de-Figueiredo
BACKGROUND: The Nephrology Unit at São Lucas Hospital, a University Hospital in Southern Brazil, has recently reached 35 years since its first kidney transplant. Few centers in the area have made a longitudinal analysis of processes, problems, grafts, and patient survival changes along this time. METHODS: A single-center, retrospective study was performed. Data were separated into different eras, based on the nature of immunosuppression used: pre-cyclosporine (1978-1986), cyclosporine (1987-1997), mycophenolate introduction (1998-2002), new immunosuppressant drugs (2003-2007), and the current period (2008-2013)...
September 2016: Transplantation Proceedings
Maria Stepanova, Trevor Locklear, Nila Rafiq, Alita Mishra, Chapy Venkatesan, Zobair M Younossi
BACKGROUND: Chronic HCV infection is often considered a contraindication for receiving a heart transplantation. METHODS: From the Scientific Registry of Transplant Recipients, we selected all adults with and without HCV infection who underwent a single organ heart transplantation in 1995-2013; the mortality status was updated in September 2015. RESULTS: A total of 32,812 heart transplant recipients were included; N=756 (2.30%) HCV-positive...
October 14, 2016: Clinical Transplantation
Riccardo Calafiore, Giuseppe Basta, Pia Montanucci
Microencapsulation technology, based on use of alginic acid biopolymers, has been devised many years ago. However, when intended for enveloping human islets for transplantation purposes, the method needs to be up-scaled and implemented with care being taken to comply with simple but important measures. It is almost indispensable to rely on an ultrapurified alginic polymers: in fact, any, even minimal, alginate contamination with endotoxins, pyrogens, and proteins could provoke the host's inflammatory reaction upon graft, with heavy adverse consequences on the capsules immunoprotective properties, hence on graft survival per se...
2017: Methods in Molecular Biology
I Dedinská, Ľ Laca, J Miklušica, D Kantárová, P Galajda, M Mokáň
BACKGROUND: New-onset diabetes mellitus after transplantation (NODAT) is a well-known complication of transplantation. OBJECTIVE: To determine the correlation between CMV infection and NODAT. METHODS: Retrospectively, we detected CMV replication (PCR) in every month after renal transplantation in the first 12 months of the procedure in a homogenous group of patients from the immunosuppression point of view. RESULTS: In 167 patients (64 with NODAT and 103 in the control group), the average amount of CMV viremia was not significantly different between the NODAT and the control group (p=0...
2016: International Journal of Organ Transplantation Medicine
M-O Timsit, F Kleinclauss, V Richard, R Thuret
OBJECTIVE: To report the nature, incidence, diagnosis and treatment options of surgical complications after renal transplantation. MATERIAL AND METHODS: Relevant publications were identified through Medline ( and Embase ( database from 1960 to 2016 using the following keywords "fistula; lymphocele; stricture; thrombosis", in association with "renal transplantation" in Title/Abstract field. Articles were selected according to methods, language of publication and relevance...
October 5, 2016: Progrès en Urologie
Hiroki Adachi, Kanae Nakayama, Norifumi Hayashi, Yuki Matsui, Keiji Fujimoto, Hideki Yamaya, Hisao Tonami, Hitoshi Yokoyama
BACKGROUND: A few studies have investigated the role of adiponectin fraction for cardiovascular disease (CVD) in RTx recipients. SUBJECTS AND METHODS: We studied 57 adult subjects (39 males, 18 females; 10 cadaveric donors) with at least three years of allograft survival (median 251 months). We examined clinical backgrounds such as treated drugs, blood pressure (BP, mmHg), body mass index (BMI), and blood chemistry including cholesterol (total, LDL-C, HDL-C), glucose, glycated hemoglobin (HbA1c), and serum high and low-molecular-weight (HMW/LMW) ADPN fractions with regard to the associations of the visceral and subcutaneous fat areas on CT scan...
2016: PloS One
Thomas Vanhove, Quinten Remijsen, Dirk Kuypers, Pieter Gillard
Post-transplant diabetes mellitus is a frequent complication of solid organ transplantation that generally requires treatment with lifestyle interventions and antidiabetic medication. A number of demonstrated and potential pharmacokinetic drug-drug interactions (DDIs) exist between commonly used immunosuppressants and antidiabetic drugs, which are comprehensively summarized in this review. Cyclosporine (CsA) itself inhibits the cytochrome P450 (CYP) 3A4 enzyme and a variety of drug transporters. As a result, it increases exposure to repaglinide and sitagliptin, will likely increase the exposure to nateglinide, glyburide, saxagliptin, vildagliptin and alogliptin, and could theoretically increase the exposure to gliquidone and several sodium-glucose transporter (SGLT)-2 inhibitors...
September 14, 2016: Transplantation Reviews
Maria P Martinez Cantarin, Scott W Keith, Zhao Lin, Cataldo Doria, Adam M Frank, Warren R Maley, Carlo Ramirez, Costas D Lallas, Ashesh Shah, Scott A Waldman, Bonita Falkner
BACKGROUND/OBJECTIVE: Post-transplant diabetes mellitus (PTDM) is both common and associated with poor outcomes after kidney transplantation. Our objective was to examine relationships of uremia-associated inflammation and adiponectin with PTDM. METHODS: Nondiabetic kidney transplant patients were enrolled with donor controls. Inflammatory cytokines and adiponectin were measured before and after transplantation. Adipose tissue was obtained for gene expression analysis...
August 2016: Cardiorenal Medicine
R M Nygaard, A M Sirany, E A Wyman, J Bodner, C J Richardson, A L Ney, M D Odland, M J Hill
Preoperative risk assessment of potential kidney transplant recipients often fails to adequately balance risk related to underlying comorbidities with the beneficial impact of kidney transplantation. We sought to develop a simple scoring system based on factors known at the time of patient assessment for placement on the waitlist to predict likelihood of severe adverse events one year post-transplant. The tool includes four components: age, cardiopulmonary factors, functional status, and metabolic factors. Pre-transplant factors strongly associated with severe adverse events include: diabetic (OR 3...
September 20, 2016: Clinical Transplantation
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
Yung Fong Tsai, Hsiu Pin Chen, Fu Chao Liu, Shih Hao Liu, Chun Yu Chen, Chih Wen Cheng, Jr Rung Lin
Post-transplant malignancy is a major cause of late mortality for liver transplant recipients (LTRs). This nationwide population-based cohort study investigated the cancer type, incidence, and risk factors associated with post-transplant malignancies in 2938 Taiwanese LTRs who underwent transplantation between 1998 and 2012. Data from the National Health Insurance Research Database were extracted on the basis of the International Classification of Disease, Ninth Revision, Clinical Modification codes. Among these patients, 284 post-transplant malignancies were diagnosed...
September 10, 2016: Oncotarget
Eugene Han, Myoung Soo Kim, Yu Seun Kim, Eun Seok Kang
The success rate of organ transplantation has been increasing with advances in surgical and pharmacological techniques. However, the number of solid organ transplant recipients who require metabolic disease management is also growing. Post-transplant diabetes mellitus (PTDM) is a common complication after solid organ transplantation and is associated with risks of graft loss, cardiovascular morbidity, and mortality. Other risk factors for PTDM include older age, genetic background, obesity, hepatitis C virus infection, hypomagnesemia, and use of immunosuppressant agents (corticosteroids, calcineurin inhibitors, and mammalian target of rapamycin inhibitor)...
October 2016: Metabolism: Clinical and Experimental
R Paul Robertson
This Perspective provides a brief history of intrahepatic alloislet and autoislet transplantation in humans and an update of the recent success rates. It also examines the important role that hypoglycemia plays in clinical outcomes. On the one hand, recurrent serious hypoglycemic episodes related to insulin therapy are a major criterion for alloislet transplantation. On the other hand, spontaneous clinical hypoglycemia, perhaps related to the accompanying Roux-en-Y procedure for total pancreatectomy, is a complication of autoislet transplantation...
October 2016: Journal of Clinical Endocrinology and Metabolism
Miguel Jiménez-Pérez, Rocío González-Grande, Edith Omonte Guzmán, Víctor Amo Trillo, Juan Miguel Rodrigo López
The metabolic syndrome (MS), which includes obesity, dyslipidaemia, hypertension and hyperglycaemia according to the most widely accepted definitions now used, is one of the most common post-transplant complications, with a prevalence of 44%-58%. The MS, together with the immunosuppression, is considered the main risk factor for the development of cardiovascular disease (CVD) in transplant recipients, which in turn accounts for 19%-42% of all deaths unrelated to the graft. The presence of MS represents a relative risk for the development of CVD and death of 1...
July 28, 2016: World Journal of Gastroenterology: WJG
Afsaneh Fazili, Soghra Gholami, Bagher Minaie Zangi, Ehsan Seyedjafari, Mahdi Gholami
OBJECTIVE: This study examined the in vivo differentiation of mesenchymal stem cells (MSCs) into insulin producing cells (IPCs) on electrospun poly-L-lactide acid (PLLA) scaffolds coated with Matricaria chammomila L. (chamomile) oil. MATERIALS AND METHODS: In this interventional, experimental study adipose MSCs (AMSCs) were isolated from 12 adult male New Zealand white rabbits and characterized by flow cytometry. AMSCs were subsequently differentiated into osteogenic and adipogenic lines...
2016: Cell Journal
Keiko Omori, Eiji Kobayashi, Jeffrey Rawson, Masafumi Takahashi, Yoko Mullen
Prolonged pancreas cold ischemia is known to negatively correlate with islet isolation outcomes, hindering successful islet transplantation to treat Type-1 Diabetes. Due to poor islet isolation outcome, pancreata with over 16 h cold ischemia are currently not considered for islet transplantation. Mechanisms involved in pancreas cold ischemia/rewarming mediated islet damage during islet isolation and culture are not well understood. Using an en bloc cold preserved rat pancreas preparation, we attempted to clarify possible mechanisms of islet death associated with prolonged pancreas cold ischemia and subsequent rewarming...
October 2016: Cryobiology
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