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Post-transplantation diabetes

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https://www.readbyqxmd.com/read/29665413/genetic-risk-factors-for-post-transplantation-diabetes-mellitus-in-chinese-han-renal-allograft-recipients-treated-with-tacrolimus
#1
Xiaoming Zhang, Tongyi Men, Haitao Liu, Xianduo Li, Jianning Wang, Jiaju Lv
BACKGROUND: Post-transplantation diabetes mellitus (PTDM) is a serious metabolic complication after kidney transplantation. The aim of this study was to explore the association of clinical variables and five selected single nucleotide polymorphisms (SNPs) with PTDM in Chinese Han renal allograft recipients taking tacrolimus (TAC). METHODS: A total of 129 non-diabetic, primary, Chinese Han renal allograft recipients treated with TAC were enrolled. Five SNPs (CYP3A5 rs776741, rs776746, rs15524, CYP24A1 rs2296241, and PPARG rs1801282) were genotyped and analyzed...
April 14, 2018: Transplant Immunology
https://www.readbyqxmd.com/read/29629485/has-the-time-come-to-be-more-aggressive-with-bariatric-surgery-in-obese-patients-with-chronic-systolic-heart-failure
#2
REVIEW
Amanda R Vest
PURPOSE OF REVIEW: Obesity is a strong risk factor for the development of heart failure (HF). Diet, exercise, and weight-loss pharmacotherapies have limited potential to achieve significant and sustainable weight loss, especially in patients with symptomatic systolic HF. This review seeks to determine the role of bariatric surgery for patients with systolic HF and obesity. RECENT FINDINGS: Bariatric surgeries such as the laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) represent the most successful long-term strategy for achieving weight loss and diabetes and hypertension remission in the general obese population...
April 8, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29622669/secular-trends-in-infection-related-mortality-after-kidney-transplantation
#3
Susanna Kinnunen, Pauli Karhapää, Auni Juutilainen, Patrik Finne, Ilkka Helanterä
BACKGROUND AND OBJECTIVES: Infections are the most common noncardiovascular causes of death after kidney transplantation. We analyzed the current infection-related mortality among kidney transplant recipients in a nationwide cohort in Finland. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Altogether, 3249 adult recipients of a first kidney transplant from 1990 to 2012 were included. Infectious causes of death were analyzed, and the mortality rates for infections were compared between two eras (1990-1999 and 2000-2012)...
April 5, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29622345/early-islets-and-mesenchyme-from-an-injured-adult-pancreas-improve-syngeneic-engraftments-and-islet-graft-function-in-diabetic-rats
#4
Venant Tchokonte-Nana, Juziel Kampando Manda
A decrease in mass of isografts and a decline in islet function are major challenges in islet transplantations. Despite this, transplantation of 84 h harvested pancreatic duct ligation (PDL) tissues have been shown to have the same functional ability to foetal pancreata, but there was only 40% success in reverting hyperglycaemia. We tested the potential of early islets with mesenchymal stromal cells (MSCs) to promote isogeneic grafts survival and to restore normoglycemia in diabetic rats, in comparison with late islets...
April 2, 2018: Acta Histochemica
https://www.readbyqxmd.com/read/29621269/artificial-neural-network-model-for-predicting-the-bioavailability-of-tacrolimus-in-patients-with-renal-transplantation
#5
Kalluri Thishya, Kiran Kumar Vattam, Shaik Mohammad Naushad, Shree Bhushan Raju, Vijay Kumar Kutala
The objective of the current study was to explore the role of ABCB1 and CYP3A5 genetic polymorphisms in predicting the bioavailability of tacrolimus and the risk for post-transplant diabetes. Artificial neural network (ANN) and logistic regression (LR) models were used to predict the bioavailability of tacrolimus and risk for post-transplant diabetes, respectively. The five-fold cross-validation of ANN model showed good correlation with the experimental data of bioavailability (r2 = 0.93-0.96). Younger age, male gender, optimal body mass index were shown to exhibit lower bioavailability of tacrolimus...
2018: PloS One
https://www.readbyqxmd.com/read/29619563/post-transplantation-diabetes-in-kidney-transplant-recipients-an-update-on-management-and-prevention
#6
Caterina Conte, Antonio Secchi
Post-transplantation diabetes mellitus (PTDM) may severely impact both short- and long-term outcomes of kidney transplant recipients in terms of graft and patient survival. However, PTDM often goes undiagnosed is underestimated or poorly managed. A diagnosis of PTDM should be delayed until the patient is on stable maintenance doses of immunosuppressive drugs, with stable kidney graft function and in the absence of acute infections. Risk factors for PTDM should be assessed during the pre-transplant evaluation period, in order to reduce the likelihood of developing diabetes...
April 4, 2018: Acta Diabetologica
https://www.readbyqxmd.com/read/29602266/cmv-infection-in-heart-transplantation-a-single-center-experience
#7
Ignacio A Echenique, Michael P Angarone, Jonathan Rich, Allen S Anderson, Valentina Stosor
BACKGROUND: CMV infection remains a major complication after heart transplantation with varying prophylaxis strategies employed. We sought to determine the impact of valganciclovir (VGC) duration on the epidemiology of CMV infections after heart transplantation. METHODS: We performed a prospective cohort study of CMV donor (D) or recipient (R) seropositive heart transplant recipients from 2005-2012 who completed VGC prophylaxis, ranging from 3-12 months according to serostatus and induction immunosuppression...
March 30, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29577581/hcv-eradication-with-new-ifn-free-treatment-improves-metabolic-profile-in-hcv-related-liver-transplant-recipients
#8
Junaid Beig, David Orr, Barry Harrison, Edward Gane
BACKGROUND AND OBJECTIVES: The new direct antiviral agents (DAAs) provide a safe and efficacious treatment for liver transplant recipients with recurrent HCV infection. The aim of this study is to evaluate the impact of HCV eradication on the metabolic factors in liver transplant recipients. METHODS: Retrospective single centre study on HCV-related liver transplant recipients treated with IFN free DAA's including both treatment naive and treatment-experienced patients...
March 25, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29573563/quality-quantity-control-culture-enhances-vasculogenesis-and-wound-healing-efficacy-of-human-diabetic-peripheral-blood-cd34-cells
#9
Rica Tanaka, Haruchika Masuda, Satoshi Fujimura, Rie Ito-Hirano, Kayo Arita, Yusuke Kakinuma, Hiroko Hagiwara, Makiko Kado, Ayato Hayashi, Tomoya Mita, Takasuke Ogawa, Hirotaka Watada, Hiroshi Mizuno, Naoki Sawada, Takayuki Asahara
Autologous endothelial progenitor cell (EPC) therapy is commonly used to stimulate angiogenesis in ischemic repair and wound healing. However, low total numbers and functional deficits of EPCs make autologous EPC therapy ineffective in diabetes. Currently, no known ex vivo culture techniques can expand and/or ameliorate the functional deficits of EPCs for clinical usage. Recently, we showed that a quality-quantity culture (QQc) system restores the vasculogenic and wound-healing efficacy of murine diabetic EPCs...
March 24, 2018: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29569832/bone-marrow-derived-mesenchymal-stem-cells-protect-islet-grafts-against-endoplasmic-reticulum-stress-induced-apoptosis-during-the-early-stage-after-transplantation
#10
Ying He, Dongmei Zhang, Yi Zeng, Junlei Ma, Jing Wang, Hui Guo, Ji Zhang, Mengqin Wang, Weijie Zhang, Nianqiao Gong
Early loss of grafted islets is the main obstacle to achieve favorable outcomes of islet transplantation. Mesenchymal stem cells are known to have a protective effect; however, its mechanism remains unclear. We hypothesized that bone marrow-derived mesenchymal stem cells (BMSCs) can protect grafted islets against endoplasmic reticulum stress (ERS)-induced apoptosis. In syngeneic streptozocin-induced diabetic BALB/c mice, islet grafts decreased blood glucose levels; however, the effect was not fully functional from the immediate post-transplant phase...
March 23, 2018: Stem Cells
https://www.readbyqxmd.com/read/29568659/primary-nocardia-infection-causing-a-fluorodeoxyglucose-avid-right-renal-mass-in-a-redo-lung-transplant-recipient
#11
Sreeja Biswas Roy, Mitchell D Ross, Pradnya D Patil, Richard Trepeta, Ross M Bremner, Tanmay S Panchabhai
Immunosuppression after lung transplantation may increase susceptibility to opportunistic infection and is associated with early and delayed deaths in lung transplant recipients. Factors that may predispose lung transplant recipients to opportunistic bacterial and fungal infections include prolonged corticosteroid use, renal impairment, treatment of acute rejection, and post-transplant diabetes mellitus. We present a unique case of a 63-year-old woman with diabetes mellitus who underwent redo lung transplantation...
2018: Case Reports in Transplantation
https://www.readbyqxmd.com/read/29563196/improved-health-related-quality-of-life-in-a-phase-3-islet-transplantation-trial-in-type-1-diabetes-complicated-by-severe-hypoglycemia
#12
Eric D Foster, Nancy D Bridges, Irene D Feurer, Thomas L Eggerman, Lawrence G Hunsicker, Rodolfo Alejandro
OBJECTIVE: Attaining glycemic targets without severe hypoglycemic events (SHEs) is a challenging treatment goal for patients with type 1 diabetes complicated by impaired awareness of hypoglycemia (IAH). The CIT Consortium Protocol 07 (CIT-07) trial showed islet transplantation to be an effective treatment for subjects with IAH and intractable SHEs. We evaluated health-related quality of life (HRQOL), functional health status, and health utility before and after pancreatic islet transplantation in CIT-07 trial participants...
March 21, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29554892/immune-thrombocytopenic-purpura-presenting-in-a-patient-after-renal-transplant-for-diabetic-nephropathy
#13
Raja Muhammad Rashid, Zahid Nabi, Ahmad Zaki Ansari, Quratul-Ain Qaiser
BACKGROUND: Immune thrombocytopenic purpura (ITP) is primarily characterized by immune-mediated destruction of platelets in circulation. Major treatment options range from careful observation, steroids, immunosuppressive medications, immunoglobulins to splenectomy. Interestingly and rarely, ITP has also been reported after solid organ transplantation in patients receiving immunosuppressive medications. While the incidence of new onset ITP after solid organ transplant is comparatively well documented, new onset ITP after renal transplant has only been reported in two patients...
March 20, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29552340/a-retrospective-analysis-of-the-utility-and-safety-of-kidney-transplant-biopsies-by-nephrology-trainees-and-consultants
#14
Michael E Reschen, Andrea Mazzella, Edward Sharples
Background and aims: Dysfunction of a kidney transplant often requires histological sampling by percutaneous ultrasound-guided core needle biopsy. Transplant biopsy is more specialized than native kidney biopsy, the indications and complications are less well defined and in England are performed mainly by nephrologists. The aims of the study were to evaluate the adequacy and complication rate in living and deceased donor recipients according to training status of the nephrologist, assess the accuracy of physicians in predicting rejection, the threshold creatinine rise for biopsy, and the change in drug management post-biopsy...
April 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29532038/improving-medication-safety-and-cardiovascular-risk-factor-control-to-mitigate-disparities-in-african-american-kidney-transplant-recipients-design-and-methods
#15
Andrew J Cole, Reginald W Johnson, Leonard E Egede, Prabhakar K Baliga, David J Taber
There is a lack of data analyzing the influence of cardiovascular disease (CVD) risk factor control on graft survival disparities in African-American kidney transplant recipients. Studies in the general population indicate that CVD risk factor control is poor in African-Americans, leading to higher rates of renal failure and major acute cardiovascular events. However, with the exception of hypertension, there is no data demonstrating similar results within transplant recipients. Recent analyses conducted by our investigator group indicate that CVD risk factors, especially diabetes, are poorly controlled in African-American recipients, which likely impacts graft loss...
March 2018: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29518094/a-randomized-controlled-trial-based-algorithm-for-insulin-pump-therapy-in-hyperglycemic-patients-early-after-kidney-transplantation
#16
Johannes M Werzowa, Marcus D Säemann, Alexander Mohl, Michael Bergmann, Christopher C Kaltenecker, Wolfgang Brozek, Andreas Thomas, Michael Haidinger, Marlies Antlanger, Johannes J Kovarik, Chantal Kopecky, Peter X K Song, Klemens Budde, Julio Pascual, Manfred Hecking
Treating hyperglycemia in previously non-diabetic individuals with exogenous insulin immediately after kidney transplantation reduced the odds of developing Posttransplantation Diabetes Mellitus (PTDM) in our previous proof-of-concept clinical trial. We hypothesized that insulin-pump therapy with maximal insulin dosage during the afternoon would improve glycemic control compared to basal insulin and standard-of-care. In a multi-center, randomized, controlled trial testing insulin isophane for PTDM prevention, we added a third study arm applying continuous subcutaneous insulin lispro infusion (CSII) treatment...
2018: PloS One
https://www.readbyqxmd.com/read/29514159/ten-year-survival-of-end-stage-renal-disease-patients-treated-with-high-efficiency-online-hemodiafiltration-a-cohort-study-of-a-center-in-south-east-asia
#17
Khajohn Tiranathanagul, Paweena Susantitaphong, Nattachai Srisawat, Nanta Mahatanan, Kriang Tungsanga, Kearkiat Praditpornsilpa, Somchai Eiam-Ong
BACKGROUND: Recently, in the first hemodiafiltration (HDF) experience report from South East Asia (SEA), we reported a 3-year prospective study demonstrating the various short-term benefits of high-efficiency online HDF (OL-HDF) over high-flux hemodialysis (HD). Very few long-term survival reports of high-efficiency OL-HDF are available and the data are heterogeneous and incomplete. OBJECTIVES: The present historical cohort study was conducted to determine the long-term survival and outcome of high-efficiency OL-HDF-treated patients...
March 7, 2018: Nephron
https://www.readbyqxmd.com/read/29496021/post-myocardial-infarction-heart-failure
#18
REVIEW
M Cecilia Bahit, Ajar Kochar, Christopher B Granger
Heart failure (HF) complicating myocardial infarction (MI) is common and may be present at admission or develop during the hospitalization. Among patients with MI, there is a strong relationship between degree of HF and mortality. The optimal management of the patient with HF complicating MI varies according to time since the onset of infarction. Medical therapy for HF after MI includes early (within 24 h) initiation of angiotensin-converting enzyme inhibitors and early (within 7 days) use of aldosterone antagonists...
March 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29491518/fast-tracking-in-adult-living-donor-liver-transplantation-a-case-series-of-15-patients
#19
Pooja Bhangui, Prashant Bhangui, Nikunj Gupta, Annu Sarin Jolly, Seema Bhalotra, Nishant Sharma, A S Soin, Vijay Vohra
Background and Aims: Fast tracking (FT) for more efficacious use of resources may be difficult after living donor liver transplantation (LDLT) due to a partial liver graft, complex vascular anastomoses and longer operating time. Our study was aimed at reporting our experience with FT (on table extubation) in LDLT recipients. A secondary objective of our study was to look at defining a subgroup of patients who could be prospectively planned for FT. Methods: We studied the demographics and outcomes of 15 LDLT recipients extubated immediately in the operating suite based on an uneventful intraoperative course, haemodynamic stability after graft reperfusion and improvement of metabolic parameters post-implantation and vascular anastomoses...
February 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29488657/roux-en-y-gastric-bypass-is-an-effective-bridge-to-kidney-transplantation-results-from-a-single-center
#20
Ian A Thomas, Jeffrey J Gaynor, Tameka Joseph, Nestor De La Cruz-Munoz, Junichiro Sageshima, Warren Kupin, Linda J Chen, Gaetano Ciancio, George W Burke, Adela D Mattiazzi, David Roth, Giselle Guerra
Body mass index(BMI)>35-40kg/m2 is often a contraindication, while Roux-en-Y gastric bypass(RYGB) is performed to enable kidney transplantation. This single-center retrospective study evaluated pre- and post-transplant outcomes of 31 morbidly obese end-stage-renal-disease patients having RYGB before kidney transplantation between July,2009-June,2014. Fourteen RYGB patients were subsequently transplanted. Nineteen recipients not having GB with a BMI>36kg/m2 at transplantation were used as historical controls...
February 28, 2018: Clinical Transplantation
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