The importance of different immunosuppressive regimens in the development of posttransplant diabetes mellitus.

摘要: Solid-organ transplantation is the optimal long-term treatment for most patients with end-stage organ failure. After solid-organ transplantation, short-term graft survival significantly improved (1). However, due to chronic allograft nephropathy and death functioning graft, has not prolonged remarkably (2). Posttransplant immunosuppressive medications consist of one calcineurin inhibitors in combination mycophenolate mofetil (MMF) or azathioprine (Aza) steroids. All them have different adverse effects, among which posttransplant diabetes mellitus (PTDM) an independent risk factor cardiovascular (CV) events infections causing many transplant it may directly contribute failure (3). According criteria American Diabetes Association (4), (DM) defined by symptoms (polyuria polydipsia weight loss) plus casual plasma glucose concentration ≥ 11.1 mmol/L fasting (FPG) 7.0 2-h level following oral tolerance test (OGTT). This metabolic disorder occurring as a complication been recognized years. PTDM, decreased insulin secretion increased resistance, develops 4.9/15.9% liver patients, 4.7/11.5% kidney recipients, 15/17.5% heart lung transplants [cyclosporine A (CyA)/tacrolimus (Tac)-based regimen, respectively] (5). Risk factors PTDM can be divided into non-modifiable modifiable ones (6), prominent therapy being responsible 74% development (7). Emphasizing importance numerous studies determined outcome. On basis these studies, patient tendentiously (8) (9, 10) those developing PTDM.