scholarly journals Overview of New Onset Diabetes after Transplantation Induced by Tacrolimus

2021 ◽  
pp. 14-26
Author(s):  
Fatmah Abdullah Bakhdar
Keyword(s):  
Organ Transplantation ◽  
Digital Library ◽  
Web Of Science ◽  
Medical Databases ◽  
Post Transplant ◽  
Onset Diabetes ◽  
Immunosuppressant Regimen ◽  
Transplant Kidney ◽  
Hypoglycemic Drug ◽  
New Onset

Tacrolimus is an important therapy in the post-transplant immunosuppressant regimen. However, it is responsible for the highest incidence of a specific type of diabetes called new onset diabetes after transplantation (NODAT). The dangers of NODAT are not limited to cardiovascular or nerve diseases, but also to kidney complication that may lead to loss of transplant kidney. The aim of this article is to discuss the possible theory of NODAT induces by tacrolimus and its common therapy. In addition, this research is to enhance knowledge about the pharmacokinetic and dynamic of tacrolimus.  This review depends on research in reliable and popular medical databases which are PubMed, Google Scholar, Saudi Digital Library, and Web of Science (ISI). While the terms used to search the published researches are organ transplantation, immunosuppressant, tacrolimus, new-onset diabetes after transplantation, and hypoglycemic drug.

scholarly journals New onset diabetes after transplantation (NODAT) in renal transplant recipients: a study from tertiary care center in Kashmir, India

2018 ◽  
Vol 6 (10) ◽  
pp. 3351
Author(s):  
Mehroz Ahmed ◽  
Rahul Sudan ◽  
Imtiyaz Ahmed Wani ◽  
Muzaffar Maqsood Wani ◽  
Khurshid Ahmed Banday ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Transplantation ◽  
Organ Transplantation ◽  
Diabetes Education ◽  
Solid Organ ◽  
Post Transplantation ◽  
Post Transplant ◽  
Onset Diabetes ◽  
History Of ◽  
New Onset

Background: New onset diabetes after transplantation (NODAT) is a common entity in the post-transplant period after several types of organ transplants like kidney, liver heart and lungs. NODAT is a common complication after solid organ transplantation and has been reported to have an adverse impact on patient and allograft outcomes. Risk stratification and intervention to minimize risk should be an integral part of management of transplant recipients.Methods: A total of 100 patients who underwent renal transplantation were observed for the development of NODAT in the post transplantation period. Patients were evaluated in the pre- transplant and post-transplant period. Risk factors which were associated with the development of NODAT were analyzed.Results: Out of 100 patients, 79 were males and 21 were females. The mean age of the patients undergoing renal transplantation was 40 years. The youngest patient was 18 years old and the eldest was 64 years old. Majority of the patients were in the age group of 31 to 50 years (60 patients, 60%). The incidence of NODAT in present study was 17%. The major risk factors for the development of NODAT were identified as male sex, positive family history of diabetes, history of alcohol intake before renal transplantation, hypertriglyceridemia, post renal transplantation hypomagnesemia, proteinuria, and use of drugs like tacrolimus and prednisolone.Conclusions: NODAT has been identified as a risk factor for graft rejection, long-term graft failure, and decreased patient survival. Once NODAT has been diagnosed, specific anti-hyperglycemic therapy is essential to reach a tight glycemic control, which contributes to significantly reduced post-transplantation morbidity. Due to the importance of NODAT, diabetes education and its impact on the outcome of post-transplantation morbidity and mortality becomes crucial point of research among organ transplantation populations. Diabetes education in a group setting can be adopted for organ transplantation recipients with NODAT.

scholarly journals INCIDENCE AND RISK FACTORS OF NEW ONSET DIABETES AFTER SOLID ORGAN TRANSPLANTATION: BASKENT UNIVERSITY EXPERIENCE

2020 ◽  
Vol 104 (S3) ◽  
pp. S135-S135
Author(s):  
Gokturk Kaban ◽  
Ozlem Turhan Iyidir ◽  
Burak Sayin ◽  
Didem Turgut ◽  
Emre Karakaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Onset Diabetes ◽  
University Experience ◽  
New Onset

scholarly journals Metabolic Disorders with Kidney Transplant

2020 ◽  
Vol 15 (5) ◽  
pp. 732-742
Author(s):  
Elizabeth Cohen ◽  
Maria Korah ◽  
Glenda Callender ◽  
Renata Belfort de Aguiar ◽  
Danielle Haakinson
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Kidney Transplant ◽  
Metabolic Disorders ◽  
Diabetes Management ◽  
Controlled Trial ◽  
Cardiovascular Complications ◽  
Patient Specific ◽  
Post Transplant ◽  
Onset Diabetes ◽  
New Onset

Metabolic disorders are highly prevalent in kidney transplant candidates and recipients and can adversely affect post-transplant graft outcomes. Management of diabetes, hyperparathyroidism, and obesity presents distinct opportunities to optimize patients both before and after transplant as well as the ability to track objective data over time to assess a patient’s ability to partner effectively with the health care team and adhere to complex treatment regimens. Optimization of these particular disorders can most dramatically decrease the risk of surgical and cardiovascular complications post-transplant. Approximately 60% of nondiabetic patients experience hyperglycemia in the immediate post-transplant phase. Multiple risk factors have been identified related to development of new onset diabetes after transplant, and it is estimated that upward of 7%–30% of patients will develop new onset diabetes within the first year post-transplant. There are a number of medications studied in the kidney transplant population for diabetes management, and recent data and the risks and benefits of each regimen should be optimized. Secondary hyperparathyroidism occurs in most patients with CKD and can persist after kidney transplant in up to 66% of patients, despite an initial decrease in parathyroid hormone levels. Parathyroidectomy and medical management are the options for treatment of secondary hyperparathyroidism, but there is no randomized, controlled trial providing clear recommendations for optimal management, and patient-specific factors should be considered. Obesity is the most common metabolic disorder affecting the transplant population in both the pre- and post-transplant phases of care. Not only does obesity have associations and interactions with comorbid illnesses, such as diabetes, dyslipidemia, and cardiovascular disease, all of which increase morbidity and mortality post-transplant, but it also is intimately inter-related with access to transplantation for patients with kidney failure. We review these metabolic disorders and their management, including data in patients with kidney transplants.

scholarly journals KAPOSI SARCOMA COEXISTING WITH NEW ONSET DIABETES MELLITUS IN A 42-YEAR-OLD KIDNEY TRANSPLANT RECIPIENT: A CASE REPORT

2020 ◽  
Vol 14 (2) ◽  
pp. 147-152
Author(s):  
Sulaiman MM ◽  
◽  
Shettima J ◽  
Ummate I ◽  
Loskorima U ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Case Report ◽  
Transplant Recipient ◽  
Kidney Transplant ◽  
Kaposi Sarcoma ◽  
Lower Limbs ◽  
Post Transplant ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset

Background: Renal allograft recipients develop several complications such as infections and neoplasms. New onset diabetes mellitus is a common transplant complication but rarely coexist with Kaposi sarcoma. Case report: We report the case of a 42-year-old banker who presented with polyuria, polydipsia, polyphagia, weight loss and dark spots in the lower limbs 8 months after he had received a live-related kidney transplant in India. He is not a known diabetic and had no family history of diabetes mellitus. His post-transplant immunosuppressive drugs included Myfortic® (mycophenolate), tacrolimus and prednisolone. At presentation he was wasted, dehydrated and afebrile, with multiple hyperpigmented nodules and plaques in both his lower limbs. Random blood glucose was 38mmol/l, had 2+ glucosuria and no ketones. Biopsy of skin lesions showed features of Kaposi sarcoma. A diagnosis of post-transplant diabetes mellitus and Kaposi sarcoma was made. His treatment included soluble insulin and antibiotics. Tacrolimus was changed to sirolimus and mycophenolate was reduced to 360mg twice daily. Conclusion: Coexistence of diabetes mellitus and karposi sarcoma occurs rarely among kidney transplant recipients. Evaluation of transplant recipient who developed diabetes for malignancies such as karposi sarcoma will improve patient and graft survival.

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