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Post-transplantation diabetes mellitus

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https://www.readbyqxmd.com/read/28541443/the-impact-of-multidisciplinary-care-on-early-morbidity-and-mortality-after-heart-transplantation
#1
Marie Schmidhauser, Julien Regamey, Nathalie Pilon, Manuel Pascual, Sam Rotman, Carlo Banfi, René Prêtre, Philippe Meyer, Jean-Philippe Antonietti, Roger Hullin
OBJECTIVES: The impact of multidisciplinary care on outcome after heart transplantation (HTx) remains unclear. METHODS: This retrospective study investigates the impact of multidisciplinary care on the primary end point 1-year all-cause mortality (ACM) and the secondary end point mean acute cellular rejection (ACR) grade within the first postoperative year. RESULTS: This study includes a total 140 HTx recipients (median age: 53.5 years; males: 80%; donor/recipient gender mismatch: 38...
May 24, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28533501/post-transplant-diabetes-mellitus-after-kidney-transplant-in-hispanics-and-caucasians-treated-with-tacrolimus-based-immunosuppression
#2
Pedro W Baron, Sergio Infante, Regina Peters, Jerusalem Tilahun, Jill Weissman, Lauren Delgado, Arputharaj Higgins Kore, W Lawrence Beeson, Michael E de Vera
BACKGROUND Development of post-transplant diabetes mellitus after kidney transplant (PTDM) significantly increases kidney graft loss and mortality. Several risk factors for PTDM have been reported, including Hispanic ethnicity and the use of calcineurin inhibitors and corticosteroids. The incidence and impact of PTDM in the Hispanic kidney transplant population is unknown. MATERIAL AND METHODS We retrospectively reviewed the medical records of 155 Hispanic and 124 Caucasian patients, who were not diabetics and underwent kidney transplant between January 2006 and December 2011...
May 23, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28521870/the-use-of-statins-alone-or-in-combination-with-pioglitazone-and-other-drugs-for-the-treatment-of-non-alcoholic-fatty-liver-disease-non-alcoholic-steatohepatitis-and-related-cardiovascular-risk-an-expert-panel-statement
#3
REVIEW
Vasilios G Athyros, Theodore K Alexandrides, Helen Bilianou, Evangelos Cholongitas, Michael Doumas, Emmanuel S Ganotakis, John Goudevenos, Moses S Elisaf, Georgios Germanidis, Olga Giouleme, Asterios Karagiannis, Charalambos Karvounis, Niki Katsiki, Vasilios Kotsis, Jannis Kountouras, Evangelos Liberopoulos, Christos Pitsavos, Stergios Polyzos, Loukianos S Rallidis, Dimitrios Richter, Apostolos G Tsapas, Alexandros D Tselepis, Konstantinos Tsioufis, Konstantinos Tziomalos, Themistoklis Tzotzas, Themistoklis G Vasiliadis, Charalambos Vlachopoulos, Dimitri P Mikhailidis, Christos Mantzoros
Non-alcoholic fatty liver disease (NAFLD), the most common liver disease, is characterized by accumulation of fat (>5% of the liver tissue), in the absence of alcohol abuse or other chronic liver diseases. It is closely related to the epidemic of obesity, metabolic syndrome or type 2 diabetes mellitus (T2DM). NAFLD can cause liver inflammation and progress to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis or hepatocellular cancer (HCC). Nevertheless, cardiovascular disease (CVD) is the most common cause of death in NAFLD/NASH patients...
June 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28506774/immunomodulatory-and-protective-effects-of-adipose-tissue-derived-mesenchymal-stem-cells-in-an-allograft-islet-composite-transplantation-for-experimental-autoimmune-type-1-diabetes
#4
Jamal Mohammadi Ayenehdeh, Bahare Niknam, Shim Rasouli, Seyed Mahmoud Hashemi, Hossein Rahavi, Nima Rezaei, Masoud Soleimani, Ali Liaeiha, Mohammad Hossein Niknam, Nader Tajik
BACKGROUND: Allogeneic islet transplantation could be an ideal alternative therapy for Type 1 Diabetes Mellitus (T1DM). Adipose Tissue-derived Mesenchymal Stem Cells (AT-MSCs) characterized by immunomodulatory and protective effects may have the potential to improve the outcome of this highly immunogenic transplant. METHODS: Syngenic AT-MSCs along with allograft islets embedded in hydrogelic composite and transplanted intraperitoneally in Streptozotocin (STZ) induced diabetic C57BL/6 mice...
May 12, 2017: Immunology Letters
https://www.readbyqxmd.com/read/28470781/elevated-donor-hemoglobin-a1c-does-not-impair-early-survival-in-cardiac-transplant-recipients
#5
Jeremy T Joseph, Michael S Mulvihill, Babatunde A Yerokun, Sadé M Bell, Carmelo A Milano, Matthew G Hartwig
BACKGROUND: Orthotopic heart transplantation (OHT) is the gold-standard therapy for end-stage heart failure. An increasing deficit between suitable allograft availability and clinical demand for OHT exists. The role of donor diabetes mellitus (DM) on post-transplant recipient outcomes in OHT is controversial. The purpose of this study was to examine donor hemoglobin A1c (HbA1c) levels to identify the impact of donor glycemic control on recipient survival. METHODS: Adult OHT recipients with donor HbA1c data were identified in the UNOS database from 2010-2015...
May 3, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28461684/real-world-multicenter-experience-of-immunosuppression-minimization-among-661-liver-transplant-recipients
#6
Diego Aguiar, Diego Martínez-Urbistondo, Alberto Baroja-Mazo, Manuel de la Mata, Manuel Rodríguez-Perálvarez, Angel Rubín, Lorena Puchades, Trinidad Serrano, Jessica Montero, Antonio Cuadrado, Fernando Casafont, Magdalena Salcedo, Diego Rincón, Jose A Pons, Jose I Herrero
BACKGROUND Long-term morbidity and mortality in liver transplant recipients is frequently secondary to immunosuppression toxicity. However, data are scarce regarding immunosuppression minimization in clinical practice. MATERIAL AND METHODS In this cross-sectional, multicenter study, we reviewed the indications of immunosuppression minimization (defined as tacrolimus levels below 5 ng/mL or cyclosporine levels below 50 ng/mL) among 661 liver transplant recipients, as well as associated factors and the effect on renal function...
May 2, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28457394/early-rehospitalization-post-kidney-transplant-due-to-infectious-complications-can-we-predict-the-patients-at-risk
#7
R Leal, H Pinto, A Galvão, L Rodrigues, L Santos, C Romãozinho, F Macário, R Alves, M Campos, A Mota, A Figueiredo
INTRODUCTION: Rehospitalization early post-kidney transplant is common and has a negative impact in morbidity, graft survival, and health costs. Infection is one the most common causes, and identifying the risk factors for early readmission due to infectious complications may guide a preventive program and improve outcome. The aim of this study was to evaluate the incidence, characterize the population, and identify the risk factors associated with early readmission for infectious complications post-kidney transplantation...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28429555/management-of-mineral-and-bone-disorders-in-renal-transplant-recipients
#8
Matthew J Damasiewicz, Peter R Ebeling
The management of post-transplantation bone disease is a complex problem that remains under-appreciated in clinical practice. In these patients, pre-existing metabolic bone disorder is further impacted by the use of immunosuppressive medications (glucocorticoids and calcineurin-inhibitors), variable post-transplantation renal allograft function and post-transplantation diabetes mellitus. The treatment of post-transplantation bone loss should begin pre-transplantation. All patients active on transplant waiting lists should be screened for bone disease...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28384413/comparative-effectiveness-of-tacrolimus-based-steroid-sparing-versus-steroid-maintenance-regimens-in-kidney-transplantation-results-from-discrete-event-simulation
#9
Vibha C A Desai, Yann Ferrand, Teresa M Cavanaugh, Christina M L Kelton, J Jaime Caro, Jens Goebel, Pamela C Heaton
BACKGROUND: Corticosteroids used as immunosuppressants to prevent acute rejection (AR) and graft loss (GL) following kidney transplantation are associated with serious cardiovascular and other adverse events. Evidence from short-term randomized controlled trials suggests that many patients on a tacrolimus-based immunosuppressant regimen can withdraw from steroids without increased AR or GL risk. OBJECTIVES: To measure the long-term tradeoff between GL and adverse events for a heterogeneous-risk population and determine the optimal timing of steroid withdrawal...
April 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28365567/use-of-p53-silenced-endothelial-progenitor-cells-to-treat-ischemia-in-diabetic-peripheral-vascular-disease
#10
Nabanita Kundu, Cleyton C Domingues, Cyril Chou, Neeki Ahmadi, Sara Houston, D Joseph Jerry, Sabyasachi Sen
BACKGROUND: Peripheral vascular disease is a major diabetes mellitus-related complication. In this study, we noted that expressions of proapoptotic p53 gene and its downstream cascade gene such as p21 are upregulated in hyperglycemia. Therefore, we investigated whether p53- and p21-silenced endothelial progenitor cells (EPCs) were able to survive in hyperglycemic milieu, and whether transplantation of either p53 knockout (KO) or p21KO or p53- and p21-silenced EPCs could improve collateral vessel formation and blood flow in diabetic vaso-occlusive peripheral vascular disease mouse models...
April 1, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28340509/liver-transplant-lt-recipients-with-nonalcoholic-steatohepatitis-nash-have-lower-risk-hepatocellular-carcinoma-hcc
#11
Sara M Lewin, Neil Mehta, R Kate Kelley, John P Roberts, Francis Y Yao, Danielle Brandman
BACKGROUND: Liver transplantation is a well-established treatment for HCC in carefully selected patients. Risk factors for tumors with poor prognostic features on explant have not been well described in a national cohort. METHODS: We performed a retrospective cohort study of adult LT recipients with HCC transplanted from 4/8/12 (when explant pathology in UNOS became available) until 9/30/2014. We evaluated the association between listing diagnosis and other demographic factors with tumor features on explant using logistic regression...
March 24, 2017: Liver Transplantation
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
#12
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/28236552/postoperative-impact-of-diabetes-chronic-kidney-disease-hemodialysis-and-renal-transplant-after-total-hip-arthroplasty
#13
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
#14
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/28176480/de-novo-thrombotic-microangiopathy-following-simultaneous-pancreas-and-kidney-transplantation-managed-with-eculizumab
#15
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/28135776/long-term-renal-outcome-after-allogeneic-hemopoietic-stem-cell-transplant-a-comprehensive-analysis-of-risk-factors-in-an-asian-patient-population
#16
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 hemopoietic 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 two of the 41 patients reached stage 4 CKD and another two required dialysis. In contrast, acute kidney injury occurred in most patients, where glomerular filtration rate (GFR) suffered a mean fall of 50 mL/min/1...
April 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28101345/%C3%AE-cell-function-prior-to-liver-transplantation-contributes-to-post-operative-diabetes
#17
Tatsuki Ichikawa, Naota Taura, Hisamitsu Miyaaki, Satoshi Miuma, Hidetaka Shibata, Takuya Honda, Masaaki Hidaka, Akihiko Soyama, Mitsuhisa Takatsuki, Susumu Eguchi, Kazuhiko Nakao
Liver cirrhosis and diabetes mellitus (DM) are closely associated. The present study aimed to determine whether liver transplantation (LT) may prevent/cure DM in patients with cirrhosis and whether the degree of glucose tolerance prior to transplantation is associated with the onset of DM after transplantation. Seventy-three patients who received a living donor LT at Nagasaki University Hospital (Nagasaki, Japan) between November 2005 and December 2012 were recruited. Among them, patients were considered diabetic if they had been prescribed diabetes medications or had impaired glucose tolerance, as evidenced by an oral glucose tolerance test (OGTT)...
December 2016: Biomedical Reports
https://www.readbyqxmd.com/read/28088950/-risk-factors-for-acute-rejection-in-living-donor-kidney-transplant-recipients-in-china-a-subgroup-analysis-of-a-multi-center-registry-study
#18
X P Hu, Y Tian, T Y Zhu, J H Chen, C X Wang, X T Li, W J Xue, T Lin, L K Peng, J M Tan, G W Feng, Z S Chen, W K Han, J Dong, Y Fan, X D Zhang
Objective: To evaluate pre-and early post-transplantation risk factors for acute rejection(AR) in kidney recipients. Methods: This subgroup analysis of a multi-center registry study was conducted on living-donor kidney transplant recipients in China with 10 years of follow-up. This study analyzed 1 255 recipients including 921 males(73.4%) and with a mean age of (33±10)years. Data from patients were first analyzed with univariate analysis and then multivariate analysis was used for finding out the potential risk factors of AR...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28088775/diagnostic-accuracy-of-glycated-hemoglobin-for-post-transplantation-diabetes-mellitus-after-kidney-transplantation-systematic-review-and-meta-analysis
#19
Ana Laura Pimentel, Gabriela Cavagnolli, Joíza Lins Camargo
Background.: Early detection of post-transplantation diabetes mellitus (PTDM) allows prompt clinical and pharmacological interventions, reducing the chance of adverse outcomes. We conducted a systematic review and meta-analysis to determine the overall diagnostic accuracy of glycated hemoglobin (HbA1c) for the diagnosis of renal PTDM. Methods.: We searched MEDLINE, Embase and SCOPUS up to June 2016. Studies that included adults without previous diabetes were selected if they reported an oral glucose tolerance test as a reference test, HbA1c levels measured by standardized methods and data necessary for drawing 2 × 2 tables...
March 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28073131/evaluation-of-glutathione-peroxidase-and-kcnj11-gene-polymorphisms-in-patients-with-new-onset-diabetes-mellitus-after-renal-transplantation
#20
Gulsah Y Yalin, Sebahat Akgul, Seher Tanrikulu, Sevim Purisa, Nurdan Gul, Ayse K Uzum, Fatma O Sarvan, Mehmet S Sever, Ilhan Satman
Introduction Genetic mutations such as C599T polymorphism in glutathione peroxidase [GPX1] gene and polymorphisms in potassium channel (KCNJ11) genes have recently been proposed in the etiopathogenesis of new onset diabetes mellitus after renal transplantation (NODAT). We aimed to examine the association of GPX1 and KCNJ11 polymorphisms in NODAT. Materials and Methods This is a monocenter case-control study with a total of 118 renal transplant recipients who were divided into 2 groups; NODAT and normal glucose tolerance...
January 10, 2017: Experimental and Clinical Endocrinology & Diabetes
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