. Optimal glycaemic targets following transplantation are unknown. Understanding the impact of DM and posttransplant diabetes mellitus (PTDM) may improve patient and graft survival in transplant recipients. . To determine the perioperative and one-year outcomes after renal transplantation and whether these outcomes are affected by preexisting DM, PTDM, or glycaemia during transplant admission. . Adult recipients of renal transplants from a single centre over 5.5 years were retrospectively reviewed. Measured outcomes during transplant admission included glycaemia and complications (infective complications, acute rejection, and return to dialysis) and, at 12 months, glycaemic control and complications (cardiovascular complication, graft failure). . Of 148 patients analysed, 29 (19.6%) had DM and 27 (18.2%) developed PTDM. Following transplantation, glucose levels were higher in patients with DM and PTDM. DM patients had a longer hospital stay, had more infections, and were more likely return to dialysis. PTDM patients had increased rates of acute rejection and return to dialysis. At 1 year after transplant, there were more cardiovascular complications in DM patients compared to those without DM. . Compared to patients without DM, patients with DM or PTDM are more likely to suffer from complications perioperatively and at 12 months. Perioperative glycaemia is associated with graft function and may be a modifiable risk.
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http://dx.doi.org/10.1155/2016/8735782 | DOI Listing |
World J Transplant
December 2024
Department of Medicine, McGill University Health Centre, Montreal H4A3J1, QC, Canada.
Kidney transplantation (KT), although the best treatment option for eligible patients, entails maintaining and adhering to a life-long treatment regimen of medications, lifestyle changes, self-care, and appointments. Many patients experience uncertain outcome trajectories increasing their vulnerability and symptom burden and generating complex care needs. Even when transplants are successful, for some patients the adjustment to life post-transplant can be challenging and psychological difficulties, economic challenges and social isolation have been reported.
View Article and Find Full Text PDFJ Vasc Access
December 2024
Department of Nephrology, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China.
Background: The feasibility of creating arteriovenous (AV) access in hemodialysis patients with superior vena cava occlusion (SVCO) is debated due to impaired blood return to the right atrium. However, collateral venous networks may offer an alternative solution, allowing for the creation of peripheral AV access. This study evaluates the outcomes of AV access construction in hemodialysis patients with SVCO.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2024
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
Background: Impella RP and RP Flex can provide right ventricular (RV) support in numerous clinical situations. Notably, the redesigned RP Flex allows for an internal jugular approach compared to the femoral venous approach with RP.
Aims: We investigated the type and frequency of device-related complications as reported in the US Food and Drug Administration (FDA) Manufacturer and User Facility Experience (MAUDE) for both Impella RP and RP Flex to see if there are any differences.
Transpl Int
November 2024
Department of Immunology, Oslo University Hospital, Oslo, Norway.
Normothermic machine perfusion (NMP) is a clinical strategy to reduce renal ischemia-reperfusion injury (IRI). Optimal NMP should restore metabolism and minimize IRI induced inflammatory responses. Microdialysis was used to evaluate renal metabolism.
View Article and Find Full Text PDFBMJ Open
November 2024
Menzies School of Health Research, Casuarina, Northern Territory, Australia
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