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Post-transplantation diabetes

Valerie Jomphe, Larry C Lands, Genevieve Mailhot
An optimal nutritional status is associated with better post-transplant outcomes and survival. Post-lung transplant nutrition management is however particularly challenging as lung recipients represent a very heterogeneous group of patients in terms of age, underlying diseases, weight status and presence of comorbidities. Furthermore, the post-transplant period encompasses several stages characterized by physiological and pathophysiological changes that affect nutritional status of patients and necessitate tailored nutrition management...
June 19, 2018: Nutrients
Sevil Korkmaz-Icöz, Shiliang Li, Sivakkanan Loganathan, Tamás Radovits, Mihály Ruppert, Paige Brlecic, Alex Ali Sayour, Gábor Veres, Thomas Fleming, Maik Brune, Patrick Most, Matthias Karck, Gábor Szabó
OBJECTIVES: The use of 'marginal' hearts, such as from donors with diabetes mellitus (DM), could offer an opportunity to expand the donor pool in cardiac transplantation. Previous studies have shown that the phosphatidylinositol-3-kinase (PI3K)/Akt pathway is altered after ischaemia/reperfusion injury in the diabetic myocardium. We hypothesized that DM-induced cardiac dysfunction in donors is further impaired after heart transplantation and that PI3K/Akt-pathway alterations may be one of the underlying pathomechanisms...
June 14, 2018: Interactive Cardiovascular and Thoracic Surgery
Zhenshun Wang, Ning Li, Dongdong Lin
Objective The incidence of metabolic syndrome (MS) increases after liver transplantation. This study was performed to evaluate the impact of MS on patients' quality of life after liver transplantation. Methods We collected the medical records of 152 patients during their post-liver transplantation outpatient follow-up. Quality of life was assessed using the Medical Outcomes Study 36-Item Short Form Health Survey. Data on the patients' general condition as well as MS-related indicators were assessed in all patients...
January 1, 2018: Journal of International Medical Research
Ryutaro Iwabuchi, Shota Ikeno, Mie Kobayashi-Ishihara, Haruko Takeyama, Manabu Ato, Yasuko Tsunetsugu-Yokota, Kazutaka Terahara
Two cytokines, fms-related tyrosine kinase 3 ligand (Flt3-L) and granulocyte-macrophage colony-stimulating factor (GM-CSF) are considered to be the essential regulators of dendritic cell (DC) development in vivo . However, the combined effect of Flt3-L and GM-CSF on human DCs has not been evaluated in vivo . In this study, we, therefore, aimed at evaluating this using a humanized mouse model. Humanized non-obese diabetic/SCID/Jak3null (hNOJ) mice were constructed by transplanting hematopoietic stem cells from human umbilical cord blood into newborn NOJ mice, and in vivo transfection (IVT) was performed by hydrodynamic injection-mediated gene delivery using plasmids encoding human Flt3-L and GM-CSF...
2018: Frontiers in Immunology
Lola Sitruk, Cécile Couchoud, Maryvonne Hourmant, Philippe Tuppin, Marie-Alice Macher, Camille Legeai
The aim of this study was to describe the drug dispensing of maintenance immunosuppression treatment in 2014 for patients who received a kidney transplant in 2012, based on the data of the French national health insurance and to compare those results with the information collected in the national database for kidney recipients. For each patient, are considered all drugs dispensing with their dates of issue, the molecules and their presentations (number of pills and dosage). Among 2463 transplanted adults in 2012, 73% have received tacrolimus monohydrate, 59% mycophenolate mofetil, 54% prednisone and 20% cyclosporin in 2014...
June 7, 2018: Néphrologie & Thérapeutique
Anne-Sophie Garnier, Agnès Duveau, Martin Planchais, Jean-François Subra, Johnny Sayegh, Jean-François Augusto
Magnesium (Mg) status has recently drawn close attention in chronic kidney disease and in kidney transplant recipients. This review aims to evaluate the body of evidence linking hypomagnesemia to clinical consequences in these specific populations. After a brief summary of the main mechanisms involved in Mg regulation and of Mg status in end-stage renal disease, the review focuses on the relationship between hypomagnesemia and cardiovascular risk in kidney transplant recipients. A body of evidence in recent studies points to a negative impact of hypomagnesemia on post-transplant diabetes mellitus (PTDM) and cardiovascular risk, which currently represent the main threat for morbidity and mortality in kidney transplantation...
June 6, 2018: Nutrients
Peter Daniel Rios, Michael Skoumal, Jeffrey Liu, R Youngblood, Ekaterina Kniazeva, Andrés J Garcia, Lonnie D Shea
Islet transplantation is a promising therapeutic option for Type 1 diabetes mellitus, yet the current delivery into the hepatic portal vasculature is limited by poor engraftment. Biomaterials have been employed as a means to promote engraftment and function at extrahepatic sites, with strategies being categorized as encapsulation or microporous scaffolds that can either isolate or integrate islets with the host tissue, respectively. While these approaches are typically studied separately using distinct material platforms, herein, we developed non-degradable polyethylene glycol (PEG)-based hydrogels for islet encapsulation or as microporous scaffolds for islet seeding in order to compare the initial engraftment and function of islets in syngeneic diabetic mice...
June 5, 2018: Biotechnology and Bioengineering
Tanja Abeling, Irina Scheffner, Annika Karch, Verena Broecker, Armin Koch, Hermann Haller, Anke Schwarz, Wilfried Gwinner
Background: Identification and quantification of the relevant factors for death can improve patients' individual risk assessment and decision-making. We used a well-documented patient cohort (n = 892) in a renal transplant programme with protocol biopsies to establish multivariable Cox models for risk assessment at 3 and 12 months post-transplantation. Methods: Patients transplanted between 2000 and 2007 were observed up to 11 years (total observation 5227 patient-years; median 5...
May 31, 2018: Nephrology, Dialysis, Transplantation
L S Vest, F M Koraishy, Z Zhang, N N Lam, M A Schnitzler, V R Dharnidharka, D Axelrod, A S Naik, T A Alhamad, B L Kasiske, G P Hess, K L Lentine
While guidelines support metformin as a therapeutic option for diabetic patients with mild-to-moderate renal insufficiency, the frequency and outcomes of metformin use in kidney transplant recipients are not well described. We integrated national U.S. transplant registry data with records from a large pharmaceutical claims clearinghouse (2008-2015). Associations (adjusted hazard ratio, 95% LCL aHR95% UCL ) of diabetes regimens (with and excluding metformin) in the first year post-transplant with patient and graft survival over the subsequent year were quantified by multivariate Cox regression, adjusted for recipient, donor, and transplant factors and propensity for metformin use...
May 31, 2018: Clinical Transplantation
Wan-Chun Li, Chen-Yi Chen, Chen-Wei Kao, Pei-Chun Huang, Yi-Ta Hsieh, Tz-Yu Kuo, Tsai-Ying Chen, Hao-Yuan Chia, Jyuhn-Huarng Juang
Ductal epithelium is primarily detected in porcine neonatal pancreatic cell clusters (NPCCs) bearing grafts, suggesting that transplants might exhibit progenitor-like phenotypes. Here we found that soon after NPCC isolation, PDX1+ /insulin- and SOX9+ pancreatic progenitor-like cells dramatically increased while dual-hormonal progenitor-like cells were routinely observed in NPCC culture. After transplantation (Tx), insulin+ cells increased and PDX1+ and SOX9+ cells gradually decreased in both non-diabetic (NDM) and streptozotocin-induced diabetic (DM) grafts over 2 months...
May 29, 2018: Scientific Reports
Lei Geng, Li-Dong Wang, Jun-Jie Huang, Tian Shen, Zhuo-Yi Wang, Bing-Yi Lin, Yu-Fu Ye, Shu-Sen Zheng
BACKGROUND: Previous studies have emphasized the need to reduce tacrolimus (TAC) trough levels in the early post-liver transplantation (LT) period. However, whether late-period TAC trough levels influence the long-term outcomes of liver recipients is not clear. METHODS: We enrolled 155 adult liver recipients survived more than 3 years after living donor liver transplantation because of non-malignant liver diseases. The maintenance immunosuppressive regimens were TAC monotherapy and combined therapy with mycophenolate mofetil...
May 17, 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Gabriel Godinho Pinto, José Antonio Tesser Poloni, Diego D'Avila Paskulin, Fabio Spuldaro, Fernanda de Paris, Afonso Luís Barth, Roberto Ceratti Manfro, Elizete Keitel, Alessandro C Pasqualotto
INTRODUCTION: BK virus (BKV) infection in renal transplant patients may cause kidney allograft dysfunction and graft loss. Accurate determination of BKV viral load is critical to prevent BKV-associated nephropathy (BKVAN) but the cut-off that best predicts BKVAN remains controversial. OBJECTIVE: To evaluate the performance of a commercial and an in-house qPCR test for quantitative detection of BK virus in kidney transplant recipients. METHODS: This was a prospective study with kidney transplant recipients from two large university hospitals in Brazil...
January 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Sandesh Parajuli, Alexandra Wick, Sameer Pandeya, Brad C Astor, Jeannina Smith, Arjang Djamali, Didier A Mandelbrot
Invasive fungal infections are a feared complication in kidney transplant recipients (KTRs). Here we present the University of Wisconsin experience with five invasive fungal infections - aspergillosis, cryptococcosis, histoplasmosis, blastomycosis, and coccidioidomycosis - in KTRs transplanted between 01/01/1994 and 06/30/2014. During this period there were 128 cases of fungal infections; aspergillosis was the most common (72), followed by cryptococcosis (29), histoplasmosis (14), blastomycosis (10) and coccidioidomycosis (3)...
May 21, 2018: Clinical Transplantation
Marwa Taher Mohamed, Eman Ahmed Embaby, Awatif Labib, Mohammed El-Husseiny, Hazem Khamis, Ahmed El-Demery, Mohamed Mounir Shoukry
Stem cell therapy is a promising approach for the treatment of type 1 diabetes mellitus (T1D). Previous studies recommended regular exercise for the control of T1D. Experimental studies showed that a combination of stem cells and exercise yielded a better outcome. Yet, the effect of exercise programs following stem cell transplantation in patients with T1D has not been investigated. Thus, the current study aimed to examine the effect of a combined exercise program on measures of glycemic control in patients with T1D who received autologous bone marrow stem cell transplantation (ABMSCT)...
May 18, 2018: Physiotherapy Theory and Practice
David M Newland, Angelina R Edwards, Reed C Hall, Pamela R Maxwell
Purpose: Post-transplant diabetes mellitus (PTDM) can lead to significant morbidity and cardiovascular death with a functioning graft. A paucity of literature exists regarding glycemic control in solid-organ transplant (SOT) recipients, including pharmacist management of PTDM. This study aimed to assess the impact of pharmacist interventions on diabetes management in a pharmacist-run PTDM clinic. Methods: This was a single-center, prospective, observational study of 24 adult SOT recipients enrolled in a pilot pharmacist-managed PTDM clinic from 1 January to 30 June 2015...
May 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
Larissa Sgaria Pacheco, Valter Duro Garcia, Ronivan Luis Dal Prá, Bruna Doleys Cardoso, Mariana Ferras Rodrigues, Helen Kris Zanetti, Gisele Meinerz, Jorge Neumann, Diego Gnatta, Elizete Keitel
INTRODUCTION: Currently, there is no specific immunosuppressive protocol for hepatitis C (HCV)-positive renal transplants recipients. Thus, the aim of this study was to evaluate the conversion effect to everolimus (EVR) on HCV in adult kidney recipients. METHOD: This is an exploratory single-center, prospective, randomized, open label controlled trial with renal allograft recipients with HCV-positive serology. Participants were randomized for conversion to EVR or maintenance of calcineurin inhibitors...
May 14, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Ahmed A Arzouni, Andreia Vargas-Seymour, Nance Nardi, Aileen J F King, Peter M Jones
Islet transplantation has the potential to cure Type 1 diabetes but current clinical transplantation protocols are inefficient because of the extensive loss of functional islets during the immediate post-transplantation period. Studies in rodent models have demonstrated that co-transplanting mesencyhmal stromal cells (MSCs) with islets improves graft functional survival and transplantation outcomes, and some of the beneficial effects of MSCs are attributable to bioactive molecules secreted by MSCs. Clinical islet transplantation is almost exclusively via the hepatic portal vein, which does not facilitate co-engraftment of islets and MSCs so attention is currently focused on using cell-free cocktails of MSC-derived products to treat islets prior to transplantation...
May 11, 2018: Stem Cells Translational Medicine
James M Mathew, Jessica H-Voss, Ann LeFever, Iwona Konieczna, Cheryl Stratton, Jie He, Xuemei Huang, Lorenzo Gallon, Anton Skaro, Mohammed Javeed Ansari, Joseph R Leventhal
There is considerable interest in therapeutic transfer of regulatory T cells (Tregs) for controlling aberrant immune responses. Initial clinical trials have shown the safety of Tregs in hematopoietic stem cell transplant recipients and subjects with juvenile diabetes. Our hypothesis is that infusion(s) of Tregs may induce transplant tolerance thus avoiding long-term use of toxic immunosuppressive agents that cause increased morbidity/mortality. Towards testing our hypothesis, we conducted a phase I dose escalation safety trial infusing billions of ex vivo expanded recipient polyclonal Tregs into living donor kidney transplant recipients...
May 9, 2018: Scientific Reports
Yoshinobu Takahashi, Keisuke Sekine, Tatsuya Kin, Takanori Takebe, Hideki Taniguchi
Clinical transplantation of tissue fragments, including islets, faces a critical challenge because of a lack of effective strategies that ensure efficient engraftment through the timely integration of vascular networks. We recently developed a complex organoid engineering method by "self-condensation" culture based on mesenchymal cell-dependent contraction, thereby enabling dissociated heterotypic lineages including endothelial cells to self-organize in a spatiotemporal manner. Here, we report the successful adaptation of this method for generating complex tissues from diverse tissue fragments derived from various organs, including pancreatic islets...
May 8, 2018: Cell Reports
Monika Fazekas-Lavu, Michael Reyes, Monique Malouf, Marshall Plit, Adrian Havryk, Lesley V Campbell, Jacqueline R Center, Allan R Glanville, Jerry R Greenfield
BACKGROUND: Diabetes increases morbidity and mortality of lung transplantation. However, the reported prevalence of diabetes varies post-transplantation partly due to lack of detection protocols. AIMS: We determined the prevalence of diabetes in patients (i) waitlisted for lung transplant and (ii) early post-transplantation. METHODS: We analyzed patients on the St Vincent's Heart Lung database from 1/4/14 to 30/9/15 on the waitlist (Study 1) and those transplanted (Study 2)...
May 9, 2018: Internal Medicine Journal
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