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Post-transplantation diabetes

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https://www.readbyqxmd.com/read/28324003/biliary-anomalies-in-patients-with-hnf1b-diabetes
#1
Jarno Lt Kettunen, Helka Parviainen, Päivi J Miettinen, Martti Färkkilä, Marjo Tamminen, Pia Salonen, Eila Lantto, Tiinamaija Tuomi
Context: The clinical spectrum of organogenetic anomalies associated with HNF1B mutations is heterogeneous. Besides cystic kidney disease, diabetes, and various other manifestations, odd cases of mainly neonatal and post-transplant cholestasis have been described. The biliary phenotype is incompletely defined. Objective: To systematically characterize HNF1B-related anomalies in the bile ducts by imaging with MRI or MRCP. Setting and Patients: Fourteen patients with HNF1B mutations in the catchment area of the Helsinki University hospital were evaluated with upper abdominal MRI and MRCP...
March 17, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28319564/improvement-in-the-outcomes-of-meld-%C3%A2-40-liver-transplantation-an-analysis-of-207-consecutive-transplants-in-a-highly-competitive-dsa
#2
Victor Nekrasov, Lea Matsuoka, Navpreet Kaur, Alejandro Pita, Gilbert Whang, Shu Cao, Susan Groshen, Sophoclis Alexopoulos
BACKGROUND: Organ donor shortages continue to persist, especially in regions of the United States where competition is highest and recipients frequently attain a MELD score ≥ 40 prior to transplantation. The benefits of Share 35 in highly competitive regions may be underestimated when examining the collective national experience. The purpose of this study is to examine the outcomes of liver transplantation in recipients with a MELD ≥ 40 after implementation of Share 35 in a single center located in region 5...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28302502/clinical-relevance-of-the-international-society-for-heart-and-lung-transplantation-consensus-classification-of-primary-graft-dysfunction-after-heart-transplantation-epidemiology-risk-factors-and-outcomes
#3
Mario Sabatino, Giuseppe Vitale, Valentina Manfredini, Marco Masetti, Laura Borgese, Giuseppe Maria Raffa, Antonio Loforte, Sofia Martin Suarez, Calogero Falletta, Giuseppe Marinelli, Francesco Clemenza, Francesco Grigioni, Luciano Potena
BACKGROUND: Primary graft dysfunction (P-GD) is the leading cause of early mortality after heart transplantation (HT). In this 2-center study we analyze outcomes and risk factors of P-GD according to the recent consensus conference classification endorsed by International Society for Heart and Lung Transplantation. METHODS: We included all adult HTs performed between 1999 and 2013. P-GD was graded as mild, moderate, and severe, according to International Society for Heart and Lung Transplantation recommendations, and analyzed separately from secondary GD...
February 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28299838/pilot-cohort-study-on-the-potential-role-of-tcf7l2-rs7903146-on-ischemic-heart-disease-among-non-diabetic-kidney-transplant-recipients
#4
Marco Quaglia, Claudio Musetti, Guido Merlotti, Armando A Genazzani, Sarah Cargnin, Tiziana Cena, Vincenzo Cantaluppi, Salvatore Terrazzino
BACKGROUND: TCF7L2 rs7903146 C>T polymorphism is associated with diabetes in the general population but its independent impact on cardiovascular disease is debated. On this basis we investigated its association with major adverse cardiac events (MACE) in a single-center cohort of non-diabetic kidney transplant recipients (KTRs). METHODS: Patients with pre-transplant diabetes were excluded and patients who developed post-transplant diabetes were censored at time of diagnosis...
March 16, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28275376/immunological-balance-is-associated-with-clinical-outcome-after-autologous-hematopoietic-stem-cell-transplantation-in-type-1-diabetes
#5
Kelen C R Malmegrim, Júlia T C de Azevedo, Lucas C M Arruda, Joana R F Abreu, Carlos E B Couri, Gislane L V de Oliveira, Patricia V B Palma, Gabriela T Scortegagna, Ana B P L Stracieri, Daniela A Moraes, Juliana B E Dias, Fabiano Pieroni, Renato Cunha, Luiza Guilherme, Nathália M Santos, Milton C Foss, Dimas T Covas, Richard K Burt, Belinda P Simões, Júlio C Voltarelli, Bart O Roep, Maria C Oliveira
Autologous hematopoietic stem cell transplantation (AHSCT) increases C-peptide levels and induces insulin independence in patients with type 1 diabetes. This study aimed to investigate how clinical outcomes may associate with the immunological status, especially concerning the balance between immunoregulation and autoreactivity. Twenty-one type 1 diabetes patients were monitored after AHSCT and assessed every 6 months for duration of insulin independence, C-peptide levels, frequencies of islet-specific autoreactive CD8(+) T cells (CTL), regulatory lymphocyte subsets, thymic function, and T-cell repertoire diversity...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28270107/incidence-of-cardiovascular-events-and-associated-risk-factors-in-kidney-transplant-patients-a-competing-risks-survival-analysis
#6
María Teresa Seoane-Pillado, Salvador Pita-Fernández, Francisco Valdés-Cañedo, Rocio Seijo-Bestilleiro, Sonia Pértega-Díaz, Constantino Fernández-Rivera, Ángel Alonso-Hernández, Cristina González-Martín, Vanesa Balboa-Barreiro
BACKGROUND: The high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients. METHODS: An observational ambispective follow-up study of renal transplant recipients (n = 2029) in the health district of A Coruña (Spain) during the period 1981-2011 was completed...
March 7, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28259681/stem-cell-laden-hyaluronic-acid-based-spongy-like-hydrogels-for-an-integrated-healing-of-diabetic-wounds-pathophysiologies
#7
Lucília Pereira da Silva, Tírcia Carlos Santos, Daniel Barreira Rodrigues, Rogério Pedro Pirraco, Mariana Teixeira Cerqueira, Rui Luís Reis, Vitor Manuel Correlo, Alexandra Pinto Marques
The correlation between the pathophysiologies of diabetic foot ulcerations is yet to be established and improved treatments are still required. We propose a strategy that directs inflammation, neo-vascularization and neo-innervation of diabetic wounds. Aiming to potentiate a relevant secretome for nerve regeneration, stem cells were pre-cultured in hyaluronic acid-based spongy-like hydrogels under neurogenic/standard media prior transplantation into diabetic mice full-thickness wounds. Acellular spongy-like hydrogels and empty wounds were used as controls...
March 1, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28245187/influence-of-genetic-polymorphisms-of-cyp3a5-and-abcb1-on-sirolimus-pharmacokinetics-patient-and-graft-survival-and-other-clinical-outcomes-in-renal-transplant
#8
Consuelo Rodríguez-Jiménez, Mar García-Saiz, Lourdes Pérez-Tamajón, Eduardo Salido, Armando Torres
BACKGROUND: In transplant patients receiving de novo anticalcineurin-free sirolimus (SRL)-based immunosuppression, we determined the influence of cytochrome P450 3A5 (CYP3A5) and ATP-binding cassette, sub-family B (MDR/TAP), member (ABCB1) genotypes on SRL blood levels and medium-term relevant clinical outcomes, in order to improve effectiveness of immunosuppression strategies when anti-mammalian target of rapamycin (anti-mTOR) inhibitor is indicated for clinical reasons. METHODS: Forty-eight renal transplant recipients (suffered 48% diabetes mellitus, 91% hypertension, and 47% dyslipidemia) were genotyped for CYP3A5 (6986A>G) and ABCB1 (3435C>T) polymorphisms by polymerase chain reaction-restriction fragment length polymorphism...
March 1, 2017: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/28241392/the-high-incidence-of-severe-chronic-kidney-disease-after-intestinal-transplantation-and-its-impact-on-patient-and-graft-survival
#9
Geneviève Huard, Kishore Iyer, Jang Moon, John T Doucette, Vinay Nair, Thomas D Schiano
INTRODUCTION: Using data from the SRTR, cumulative incidence, risk factors for, and impact on survival of severe CKD in ITx recipients were assessed. METHODS: First-time adult ITx recipients transplanted in the United States between 01/01/1990 and 12/31/2012 were included. Severe CKD after ITx was defined as: GFR <30 ml/min/1.73m(2) , chronic hemodialysis initiation, or KTx. Survival analysis and extended Cox model were conducted. RESULTS: The cumulative incidence of severe CKD one, five and ten years after ITx was 3...
February 27, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28238223/glucose-lowering-agents-for-treating-pre-existing-and-new-onset-diabetes-in-kidney-transplant-recipients
#10
REVIEW
Clement Lo, Min Jun, Sunil V Badve, Helen Pilmore, Sarah L White, Carmel Hawley, Alan Cass, Vlado Perkovic, Sophia Zoungas
BACKGROUND: Kidney transplantation is the preferred form of kidney replacement therapy for patients with end-stage kidney disease (ESKD) and is often complicated by worsening or new-onset diabetes. Management of hyperglycaemia is important to reduce post-transplant and diabetes-related complications. The safety and efficacy of glucose-lowering agents after kidney transplantation is largely unknown. OBJECTIVES: To evaluate the efficacy and safety of pharmacological interventions for lowering glucose levels in patients who have undergone kidney transplantation and have diabetes...
February 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28236552/postoperative-impact-of-diabetes-chronic-kidney-disease-hemodialysis-and-renal-transplant-after-total-hip-arthroplasty
#11
Beau J Kildow, Perez Agaba, Brian F Moore, Rhett K Hallows, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: The prevalence of diabetes mellitus (DM), chronic kidney disease (CKD), hemodialysis (HD), and renal transplantation (RT) is increasing. This study assessed postoperative complications among diabetic patients with CKD, HD, or post-RT after total hip arthroplasty (THA). METHODS: Four cohorts were created using a nationwide database: DM&THA, DM&CKD&THA, DM&HD&THA, and DM&RT&THA. Cohorts were matched to a control group by age and gender. Thirty-day medical complications and 90-day and 2-year surgical complications were evaluated...
January 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28219583/risk-factors-affecting-graft-and-patient-survivals-after-transplantation-from-deceased-donors-in-a-developing-country-a-single-center-experience
#12
Y Ayar, A Ersoy, G Ocakoglu, A Yildiz, A Oruc, H Soyak, M Calapkulu, A B Sahin, N Bolca Topal, E Okeer, B Coskun, O Kaygisiz, Y Kordan, H Vuruskan
AIM: The aim of this study was to evaluate risk factors affecting graft and patient survival after transplantation from deceased donors. METHODS: We retrospectively analyzed the outcomes of 186 transplantations from deceased donors performed at our center between 2006 and 2014. The recipients were divided into two groups: Group I (141 recipients without graft loss) and Group II (45 recipients with graft loss). Kaplan-Meier, log-rank test, and Cox proportional hazard regressions were used...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28211192/racial-differences-in-incident-de-novo-donor-specific-anti-hla-antibody-among-primary-renal-allograft-recipients
#13
Matthew J Everly, Kimberly P Briley, Carl E Haisch, Georg Dieplinger, Paul Bolin, Scott A Kendrick, Claire Morgan, Angela Q Maldonado, Lorita M Rebellato
Controversy exists as to whether African American (AA) transplant recipients are at risk for developing de novo donor-specific anti-human leukocyte antigen (HLA) antibody (dnDSA). We studied 341 HLA-mismatched, primary renal allograft recipients who were consecutively transplanted between 3/1999 and 12/2010. Sera were collected sequentially pre- and post-transplant and tested for anti-HLA immunoglobulin G (IgG) via single antigen bead assay. Of the 341 transplant patients (225 AA and 116 non-AA), 107 developed dnDSA at a median of 9...
February 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28176480/de-novo-thrombotic-microangiopathy-following-simultaneous-pancreas-and-kidney-transplantation-managed-with-eculizumab
#14
REVIEW
Lani Shochet, John Kanellis, Ian Simpson, Joseph Ta, William Mulley
Thrombotic microangiopathy (TMA) is a well-recognised complication following transplantation, often due to an underlying genetic predisposition, medications or rejection. The use of eculizumab in these settings has been previously described, but its role still remains to be clarified. A 45-year-old man, with a history of type 1 diabetes mellitus and subsequent end-stage kidney failure, presented for a simultaneous pancreas-kidney transplant. Immunologically, he was well matched with the donor, and he received standard induction immunosuppression including tacrolimus...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28174291/local-sphingosine-kinase-1-activity-improves-islet-transplantation
#15
Darling Rojas-Canales, Daniella Penko, Kay K Myo Min, Kate A Parham, Heshan Peiris, Rainer V Haberberger, Stuart M Pitson, Chris Drogemuller, Damien J Keating, Shane T Grey, Patrick T Coates, Claudine S Bonder, Claire F Jessup
Pancreatic islet transplantation is a promising clinical treatment for type I diabetes (T1D), but success is limited by extensive beta cell death in the immediate post-transplant period, and impaired islet function in the longer term. Following transplantation, appropriate vascular remodelling is crucial to ensure the survival and function of engrafted islets. The sphingosine kinase pathway is an important regulator of vascular beds, but its role in the survival and function of transplanted islets is unknown...
February 7, 2017: Diabetes
https://www.readbyqxmd.com/read/28160394/cardiovascular-morbidity-and-mortality-after-liver-transplantation-the-protective-role-of-mycophenolate-mofetil
#16
Delia D'Avola, Valentín Cuervas-Mons, Josep Martí, Jorge Ortiz de Urbina, Laura Lladó, Carlos Jimenez, Esteban Otero, Francisco Suarez, Juan M Rodrigo, Miguel-Angel Gómez, Enrique Fraga, Pedro Lopez, M Trinidad Serrano, Antonio Rios, Emilio Fábrega, José Ignacio Herrero
Cardiovascular (CV) diseases are recognized longterm causes of death after liver transplantation (LT). The objective of this multicenter study was to analyze the prevalence and the evolution of CV risk factors and CV morbidity and mortality in 1819 LT recipients along 5 years after LT. The influence of baseline variables on survival, morbidity, and mortality was studied. There was a continuous and significant increase of the prevalence of all the CV risk factors (except smoking) after LT. CV diseases were the fourth cause of mortality in the 5 years after LT, causing 12% of deaths during the follow-up...
April 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28149647/hepatitis-c-and-kidney-disease-a-narrative-review
#17
REVIEW
Rashad S Barsoum, Emad A William, Soha S Khalil
Hepatitis-C (HCV) infection can induce kidney injury, mostly due to formation of immune-complexes and cryoglobulins, and possibly to a direct cytopathic effect. It may cause acute kidney injury (AKI) as a part of systemic vasculitis, and augments the risk of AKI due to other etiologies. It is responsible for mesangiocapillary or membranous glomerulonephritis, and accelerates the progression of chronic kidney disease due to other causes. HCV infection increases cardiovascular and liver-related mortality in patients on regular dialysis...
March 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28135776/long-term-renal-outcome-after-allogeneic-haemopoietic-stem-cell-transplant-a-comprehensive-analysis-of-risk-factors-in-an-asian-patient-population
#18
Wei Zhou, Rehena Sultana, Colin Diong, Yeow-Tee Goh, Sathish Gopalakrishnan, Aloysius Ho, William Hwang, Liang-Piu Koh, Mickey Koh, Yvonne Loh, Patrick Tan, Yeh-Ching Linn
Allogeneic haemopoietic stem cell transplantation (allo-HSCT) poses a significant challenge to renal function due to multiple drug- and complication-related renal toxicity. In this single center series of 216 adult Asian patients with a long and complete follow up, 41 developed chronic kidney disease (CKD) giving a cumulative incidence of 19.0% at 25 years (median follow up duration 7.84 years, range 2.0 - 27.7 years), but only 2 of the 41 patients reaching stage 4 CKD and another 2 requiring dialysis. In contrast, acute kidney injury occurred in most patients, where glomerular filtration rate (GFR) suffered a mean fall of 50ml/min/1...
January 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28122320/revisional-bariatric-surgery-in-a-transplant-patient
#19
Salman Al Sabah, Eliana Al Haddad
INTRODUCTION: A BMI of over 35-45kg/m2 is deemed the upper limit for considering a patient for a renal transplant. Voluntary weight loss attempts are a major concern for patients while on hemodialysis, however, bariatric surgeries have opened up a new door to notable weight loss results, even demonstrating significant improvements of patients' diabetic profile and hypertension. CASE REPORT: Case of a 52-year-old male with a BMI of 42 in end-stage renal disease, that needed a kidney transplant but was ineligible to be placed on the waiting list due to his weight...
January 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28121741/effect-of-early-everolimus-facilitated-reduction-of-tacrolimus-on-efficacy-and-renal-function-in-de-novo-liver-transplant-recipients-24-month-results-for-the-north-american-subpopulation
#20
William C Chapman, Robert S Brown, Kenneth D Chavin, Debra Sudan, Baburao Koneru, Guido Junge, Gaohong Dong, Dharmesh Patel, Lewis Teperman, John J Fung
BACKGROUND: A recent randomized phase III study of 719 de novo liver transplant recipients showed that early everolimus plus reduced-dose tacrolimus (EVR + rTAC) led to significantly better kidney function than standard TAC (TAC-C), without compromising efficacy. In that study, patients from North America (n = 211) had increased risk factors for posttransplant renal insufficiency at study start, relative to patients from Europe and rest of world (eg, worse renal function, more diabetes, older age)...
February 2017: Transplantation
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