Conversion to Sirolimus Therapy in Kidney Transplant Recipients with New Onset Diabetes Mellitus after Transplantation
New-onset diabetes mellitus after transplantation (NODAT) may complicate 2–50% of kidney transplantation, and it is associated with reduced graft and patient survivals. In this retrospective study, we applied a conversion protocol to sirolimus in a cohort of kidney transplant recipients with NODAT....
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | Clinical and Developmental Immunology |
| Online Access: | http://dx.doi.org/10.1155/2013/496974 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832567654684033024 |
|---|---|
| author | Massimiliano Veroux Tiziano Tallarita Daniela Corona Nunziata Sinagra Alessia Giaquinta Domenico Zerbo Carmela Guerrieri Antonino D'Assoro Sebastiano Cimino Pierfrancesco Veroux |
| author_facet | Massimiliano Veroux Tiziano Tallarita Daniela Corona Nunziata Sinagra Alessia Giaquinta Domenico Zerbo Carmela Guerrieri Antonino D'Assoro Sebastiano Cimino Pierfrancesco Veroux |
| author_sort | Massimiliano Veroux |
| collection | DOAJ |
| description | New-onset diabetes mellitus after transplantation (NODAT) may complicate 2–50% of kidney transplantation, and it is associated with reduced graft and patient survivals. In this retrospective study, we applied a conversion protocol to sirolimus in a cohort of kidney transplant recipients with NODAT. Among 344 kidney transplant recipients, 29 patients developed a NODAT (6.6%) and continued with a reduced dose of calcineurin inhibitors (CNI) (8 patients, Group A) or were converted to sirolimus (SIR) (21 patients, Group B). NODAT resolved in 37.5% and in 80% patients in Group A and Group B, respectively. In Group A, patient and graft survivals were 100% and 75%, respectively, not significantly different from Group B (83.4% and 68%, resp., P=0.847). Graft function improved after conversion to sirolimus therapy: serum creatinine was 1.8 ± 0.7 mg/dL at the time of conversion and 1.6 ± 0.4 mg/dL five years after conversion to sirolimus therapy (P<0.05), while in the group of patients remaining with a reduced dose of CNI, serum creatinine was 1.7 ± 0.6 mg/dL at the time of conversion and 1.65 ± 0.6 mg/dL at five-year followup (P=0.732). This study demonstrated that the conversion from CNI to SIR in patients could improve significantly the metabolic parameters of patients with NODAT, without increasing the risk of acute graft rejection. |
| format | Article |
| id | doaj-art-69a1d236bd9744b28648e84e68a699e1 |
| institution | Kabale University |
| issn | 1740-2522 1740-2530 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Developmental Immunology |
| spelling | doaj-art-69a1d236bd9744b28648e84e68a699e12025-02-03T01:00:54ZengWileyClinical and Developmental Immunology1740-25221740-25302013-01-01201310.1155/2013/496974496974Conversion to Sirolimus Therapy in Kidney Transplant Recipients with New Onset Diabetes Mellitus after TransplantationMassimiliano Veroux0Tiziano Tallarita1Daniela Corona2Nunziata Sinagra3Alessia Giaquinta4Domenico Zerbo5Carmela Guerrieri6Antonino D'Assoro7Sebastiano Cimino8Pierfrancesco Veroux9Vascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, 95123 Catania, ItalyVascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, 95123 Catania, ItalyVascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, 95123 Catania, ItalyVascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, 95123 Catania, ItalyVascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, 95123 Catania, ItalyVascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, 95123 Catania, ItalyVascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, 95123 Catania, ItalyMedical Oncology, Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USAVascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, 95123 Catania, ItalyVascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, 95123 Catania, ItalyNew-onset diabetes mellitus after transplantation (NODAT) may complicate 2–50% of kidney transplantation, and it is associated with reduced graft and patient survivals. In this retrospective study, we applied a conversion protocol to sirolimus in a cohort of kidney transplant recipients with NODAT. Among 344 kidney transplant recipients, 29 patients developed a NODAT (6.6%) and continued with a reduced dose of calcineurin inhibitors (CNI) (8 patients, Group A) or were converted to sirolimus (SIR) (21 patients, Group B). NODAT resolved in 37.5% and in 80% patients in Group A and Group B, respectively. In Group A, patient and graft survivals were 100% and 75%, respectively, not significantly different from Group B (83.4% and 68%, resp., P=0.847). Graft function improved after conversion to sirolimus therapy: serum creatinine was 1.8 ± 0.7 mg/dL at the time of conversion and 1.6 ± 0.4 mg/dL five years after conversion to sirolimus therapy (P<0.05), while in the group of patients remaining with a reduced dose of CNI, serum creatinine was 1.7 ± 0.6 mg/dL at the time of conversion and 1.65 ± 0.6 mg/dL at five-year followup (P=0.732). This study demonstrated that the conversion from CNI to SIR in patients could improve significantly the metabolic parameters of patients with NODAT, without increasing the risk of acute graft rejection.http://dx.doi.org/10.1155/2013/496974 |
| spellingShingle | Massimiliano Veroux Tiziano Tallarita Daniela Corona Nunziata Sinagra Alessia Giaquinta Domenico Zerbo Carmela Guerrieri Antonino D'Assoro Sebastiano Cimino Pierfrancesco Veroux Conversion to Sirolimus Therapy in Kidney Transplant Recipients with New Onset Diabetes Mellitus after Transplantation Clinical and Developmental Immunology |
| title | Conversion to Sirolimus Therapy in Kidney Transplant Recipients with New Onset Diabetes Mellitus after Transplantation |
| title_full | Conversion to Sirolimus Therapy in Kidney Transplant Recipients with New Onset Diabetes Mellitus after Transplantation |
| title_fullStr | Conversion to Sirolimus Therapy in Kidney Transplant Recipients with New Onset Diabetes Mellitus after Transplantation |
| title_full_unstemmed | Conversion to Sirolimus Therapy in Kidney Transplant Recipients with New Onset Diabetes Mellitus after Transplantation |
| title_short | Conversion to Sirolimus Therapy in Kidney Transplant Recipients with New Onset Diabetes Mellitus after Transplantation |
| title_sort | conversion to sirolimus therapy in kidney transplant recipients with new onset diabetes mellitus after transplantation |
| url | http://dx.doi.org/10.1155/2013/496974 |
| work_keys_str_mv | AT massimilianoveroux conversiontosirolimustherapyinkidneytransplantrecipientswithnewonsetdiabetesmellitusaftertransplantation AT tizianotallarita conversiontosirolimustherapyinkidneytransplantrecipientswithnewonsetdiabetesmellitusaftertransplantation AT danielacorona conversiontosirolimustherapyinkidneytransplantrecipientswithnewonsetdiabetesmellitusaftertransplantation AT nunziatasinagra conversiontosirolimustherapyinkidneytransplantrecipientswithnewonsetdiabetesmellitusaftertransplantation AT alessiagiaquinta conversiontosirolimustherapyinkidneytransplantrecipientswithnewonsetdiabetesmellitusaftertransplantation AT domenicozerbo conversiontosirolimustherapyinkidneytransplantrecipientswithnewonsetdiabetesmellitusaftertransplantation AT carmelaguerrieri conversiontosirolimustherapyinkidneytransplantrecipientswithnewonsetdiabetesmellitusaftertransplantation AT antoninodassoro conversiontosirolimustherapyinkidneytransplantrecipientswithnewonsetdiabetesmellitusaftertransplantation AT sebastianocimino conversiontosirolimustherapyinkidneytransplantrecipientswithnewonsetdiabetesmellitusaftertransplantation AT pierfrancescoveroux conversiontosirolimustherapyinkidneytransplantrecipientswithnewonsetdiabetesmellitusaftertransplantation |