Risk assessment and management of post-transplant diabetes mellitus.
The success rate of organ transplantation has been increasing with advances in surgical and pharmacological techniques. However, the number of solid organ transplant recipients who require metabolic disease management is also growing. Post-transplant diabetes mellitus (PTDM) is a common complication after solid organ transplantation and is associated with risks of graft loss, cardiovascular morbidity, and mortality. Other risk factors for PTDM include older age, genetic background, obesity, hepatitis C virus infection, hypomagnesemia, and use of immunosuppressant agents (corticosteroids, calcineurin inhibitors, and mammalian target of rapamycin inhibitor). Management of PTDM should be started before the transplantation plan to properly screen high-risk patients. Even though PTDM management is similar to that of general type 2 diabetes, therapeutic approaches must be made with consideration of drug interactions between immunosuppressive agents, glucose-lowering medications, and graft rejection and function.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Hospital Diabetes Center.
Eugene
E
Han
Department of Transplantation Surgery, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.
Myoung Soo
MS
Kim
Department of Transplantation Surgery, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.
Yu Seun
YS
Kim
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Hospital Diabetes Center; Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: endoedgo@gmail.com.
Eun Seok
ES
Kang
D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D016377:Organ Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000628:therapy*; D018570:Risk Assessment; D012307:Risk Factors
Diabetes mellitus; Management; Organ transplantation; Risk factors