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Post-transplantation diabetes mellitus

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https://www.readbyqxmd.com/read/28429555/management-of-mineral-and-bone-disorders-in-renal-transplant-recipients
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28039534/hypomagnesemia-and-increased-risk-of-new-onset-diabetes-mellitus-after-transplantation-in-pediatric-renal-transplant-recipients
#14
Wesley Hayes, Sheila Boyle, Adrian Carroll, Detlef Bockenhauer, Stephen D Marks
BACKGROUND: New-onset diabetes after transplantation (NODAT) is a significant co-morbidity following kidney transplantation. Lower post-transplant serum magnesium levels have been found to be an independent risk factor for NODAT in adult kidney transplant recipients. METHODS: We undertook a retrospective analysis of risk factors for NODAT in pediatric renal transplant recipients at our institution with the aim of determining if hypomagnesemia confers a significant risk of developing NODAT in this patient population...
May 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28013014/metabolic-complications-precede-alloreactivity-and-are-characterized-by-changes-in-suppression-of-tumorigenicity-2-signaling
#15
Romany A N Johnpulle, Sophie Paczesny, Dae Kwang Jung, Etienne Daguindau, Madan H Jagasia, Bipin N Savani, Wichai Chinratanalab, Robert F Cornell, Stacey Goodman, John P Greer, Adetola A Kassim, Salyka Sengsayadeth, Michael T Byrne, Brian G Engelhardt
New-onset post-transplantation diabetes mellitus (PTDM) occurs commonly after allogeneic hematopoietic cell transplantation (HCT) and is associated with inferior survival. We hypothesize that PTDM and nonrelapse mortality (NRM) are related to IL-33/suppression of tumorigenicity 2 (ST2) signaling and that soluble ST2 (sST2) levels will predict PTDM diagnosis. sST2 was measured at engraftment and day +30 in 36 euglycemic HCT recipients followed prospectively for PTDM (cohort 1). Results were confirmed in a validation cohort of 26 patients without pre-existing diabetes analyzed retrospectively for PTDM (cohort 2)...
March 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27980321/beta-cell-function-and-insulin-resistance-after-conversion-from-tacrolimus-twice-daily-to-extended-release-tacrolimus-once-daily-in-stable-renal-transplant-recipients
#16
Prajej Ruangkanchanasetr, Natthi Sanohdontree, Thanom Supaporn, Nattapol Sathavarodom, Bancha Satirapoj
BACKGROUND Post-transplantation diabetes mellitus is a major metabolic adverse effect of tacrolimus (TAC). The objective of this study was to determine if the conversion from tacrolimus twice-daily (TAC-BID) to extended-release tacrolimus once-daily (TAC-OD) in stable renal transplant recipients had any effect on beta cell function (HOMA-b), insulin resistance (HOMA-IR), patient preference, and expense. MATERIAL AND METHODS Twenty-eight renal transplant recipients were recruited and converted from TAC-BID to TAC-OD at the same dose...
December 16, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/27974246/micrornas-106b-and-222-improve-hyperglycemia-in-a-mouse-model-of-insulin-deficient-diabetes-via-pancreatic-%C3%AE-cell-proliferation
#17
Sohei Tsukita, Tetsuya Yamada, Kei Takahashi, Yuichiro Munakata, Shinichiro Hosaka, Hironobu Takahashi, Junhong Gao, Yuta Shirai, Shinjiro Kodama, Yoichiro Asai, Takashi Sugisawa, Yumiko Chiba, Keizo Kaneko, Kenji Uno, Shojiro Sawada, Junta Imai, Hideki Katagiri
Major symptoms of diabetes mellitus manifest, once pancreatic β-cell numbers have become inadequate. Although natural regeneration of β-cells after injury is very limited, bone marrow (BM) transplantation (BMT) promotes their regeneration through undetermined mechanism(s) involving inter-cellular (BM cell-to-β-cell) crosstalk. We found that two microRNAs (miRNAs) contribute to BMT-induced β-cell regeneration. Screening murine miRNAs in serum exosomes after BMT revealed 42 miRNAs to be increased. Two of these miRNAs (miR-106b-5p and miR-222-3p) were shown to be secreted by BM cells and increased in pancreatic islet cells after BMT...
February 2017: EBioMedicine
https://www.readbyqxmd.com/read/27943503/invasive-fungal-infection-after-heart-transplantation-a-7-year-single-center-experience
#18
Ignacio A Echenique, Michael P Angarone, Robert A Gordon, Jonathan Rich, Allen S Anderson, Edwin C McGee, Travis O Abicht, Joseph Kang, Valentina Stosor
BACKGROUND: Invasive fungal infections (IFIs) are an infrequent but major complication of heart transplantation (HT). We sought to describe the epidemiology at our institution. METHODS: A prospective cohort study of 159 heart transplant recipients was performed from June 2005 to December 2012. IFIs were defined by European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. RESULTS: By univariate analysis, Hispanic ethnicity was associated with IFI (P=...
December 10, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27941771/hyperglycemia-as-a-possible-risk-factor-for-mold-infections-the-potential-preventative-role-of-intensified-glucose-control-in-allogeneic-hematopoietic-stem-cell-transplantation
#19
REVIEW
S Fuji, J Löffler, B N Savani, H Einsele, M Kapp
Diabetes mellitus (DM) is well-known as a disorder that increases the risk of infectious diseases. Various reports have shown that innate immunity is impaired in patients with DM, which is considered to be a major cause of increased risk of infectious diseases. However, there is a paucity of data about the actual risk of mold infections in patients with DM. Several treatment procedures, such as solid organ transplantation and hematopoietic stem cell transplantation (HSCT), are intrinsically associated with a high risk of mold infections and also correlated with an increased risk of post-transplant DM...
December 12, 2016: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/27938316/two-decades-of-tacrolimus-in-renal-transplant-basic-science-and-clinical-evidences
#20
Badri Man Shrestha
Tacrolimus, a calcineurin inhibitor, has been the cornerstone of immunosuppressive regimens in renal transplant over 2 decades. This has significantly improved the outcomes of renal transplant, including reduction of acute rejection episodes, improvement of renal function and graft survival, and reduction of some of the adverse effects associated with cyclosporine. However, use of tacrolimus is associated with a number of undesirable effects, such as nephrotoxicity, posttransplant diabetes mellitus, neurotoxicity, and cosmetic and electrolyte disturbances...
February 2017: Experimental and Clinical Transplantation
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