Conversion from tacrolimus to cyclosporine A improves new-onset diabetes mellitus after transplantation

doi:10.3969/j.issn.2095-4344.2013.53.013

Abstract

Abstract:

BACKGROUND: The pathogenesis of new-onset diabetes mellitus after transplantation remains unclear. It is generally recognized that the onset is associated with patient’s ethnics, age, body weight, familial history, hepatitis C virus and immunosuppressant scheme.

OBJECTIVE: To discuss the efficiency and safety of conversion from tacrolimus to cyclosporine A in renal transplant recipients with new-onset diabetes mellitus after transplantation.

METHODS: Forty-two renal transplant recipients, who met the inclusion criteria, were divided into two groups randomly: conversion group (n=20; tacrolimus was converted to cyclosporine A) and control group (n=22; tacrolimus was given contrinuously). All the involved patients were followed up for 1 year after the diagnosis of new-onset diabetes mellitus after transplantation in control group and conversion from tacrolimus to cyclosporine A conversion group. The blood glucose levels of patients were dynamically monitored. Meanwhile body mass index, serum creatinine, urea nitrogen, serum uric acid, liver function, blood lipid, the dose and concentration range of immunosuppressants, urinary albumin, the incidence of acute rejection, infection rate of hepatitis C virus, the survival rate of patients and renal graft were all recorded.

RESULTS AND CONCLUSION: With the time going, fasting blood glucose and glycosylated hemoglobin were improved gradually in conversion group and the number of cases needing glucose-lowering treatment was gradually decreased. Eleven cases (55%) presented a complete remission after one year and needed no glucose-lowering treatment. In the control group, the cases needing glucose-lowering treatment were increased gradually, and all cases still needed glucose-lowering treatment after one year. Fasting blood glucose and glycosylated hemoglobin levels were higher than those in conversion group. Meanwhile, serum creatinine, alanine aminotransferase, triacylglycerol, cholesterol and serum uric acid showed no differences between two groups, but urinary albumin level in control group was higher than conversion group at 6 months. The incidence of acute rejection, the rate of infection, the survival rate of patient and renal graft also showed no differences between the two groups. Our findings indicate that, conversion from tacrolimus to cyclosporine A is an effective and safe strategy to improve new-onset diabetes mellitus after transplantation within a short time (less than one year).

中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程

全文链接：

Key words: organ transplantation, kidney transplantation, diabetes mellitus, hypoglycemic agents, cyclophilin A, tacrolimus binding proteins, blood glucose

CLC Number:

R318

Feng Xiao-fang, Min Min, Zuo Fu-jie, Zhou Mei-sheng, Wang Li-ming. Conversion from tacrolimus to cyclosporine A improves new-onset diabetes mellitus after transplantation[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(53): 9176-9181.

Figures/Tables 3

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