IngentaConnect Increased risk of post-transplant diabetes mellitus despite early...

Authors: Walczak, Debra A¹; Calvert, Denise¹; Jarzembowski, Tomasz M¹; Testa, Giuliano¹; Sankary, Howard N¹; Thielke, James²; Oberholzer, José¹; Benedetti, Enrico¹

Source: Clinical Transplantation, Volume 19, Number 4, August 2005 , pp. 527-531(5)

Publisher: Blackwell Publishing

Abstract:

Walczak DA, Calvert D, Jarzembowski TM, Testa G, Sankary HN, Thielke J, Oberholzer J, Benedetti E. Increased risk of post-transplant diabetes mellitus despite early steroid discontinuation in Hispanic kidney transplant recipients.

Clin Transplant 2005: 19: 527–531. © Blackwell Munksgaard, 2005 Abstract:

Early steroid discontinuation (ESD) has been associated with a lower incidence of post-transplant diabetes mellitus (PTDM). We retrospectively reviewed the incidence of PTDM in relation to racial groups in kidney transplant recipients treated with ESD. Between January 2002 and September 2003, 125 consecutive primary adult kidney transplants were performed. Group A (n = 91) had steroids discontinued on postoperative day 6 and maintenance immunosuppression of Tacrolimus and mycophenolate mofetil. Group B (n = 34), received the same immunosuppression but was maintained on steroids indefinitely. Induction consisted of thymoglobulin in African–Americans; all others received Simulect. At 1 yr, patient/graft survival, serum creatinine and rate of acute rejection were similar in both groups. The incidence of PTDM was significantly lower in group A (7%) compared with group B (26%, p = 0.0209). The incidence of PTDM in group A was limited to Hispanic patients with a family history of diabetes mellitus. African–Americans and Caucasians in group A did not experience PTDM (p = 0.005 compared with African–American in group B). Our steroid free protocol nearly eliminated the incidence of PTDM in African–Americans and Caucasians, but was still associated with significant rate of PTDM in Hispanic recipients. Alternative immunosuppression may benefit this population.

Keywords: post-transplant diabetes; steroid discontinuation

Document Type: Research article

DOI: 10.1111/j.1399-0012.2005.00383.x

Affiliations: 1: Department of Surgery, Division of Transplantation 2: Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA

The full text electronic article is available for purchase. You will be able to download the full text electronic article after payment.

$50.16 plus tax Refund Policy