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. 2011:4:175-86.
doi: 10.2147/DMSO.S19027. Epub 2011 May 9.

New onset diabetes after transplantation (NODAT): an overview

Phuong-Thu T Pham  1 , Phuong-Mai T Pham, Son V Pham, Phuong-Anh T Pham, Phuong-Chi T Pham
Affiliations

New onset diabetes after transplantation (NODAT): an overview

Phuong-Thu T Pham et al. Diabetes Metab Syndr Obes. 2011.

Abstract

Although renal transplantation ameliorates cardiovascular risk factors by restoring renal function, it introduces new cardiovascular risks including impaired glucose tolerance or diabetes mellitus, hypertension, and dyslipidemia that are derived, in part, from immunosuppressive medications such as calcineurin inhibitors, corticosteroids, or mammalian target of rapamycin inhibitors. New onset diabetes mellitus after transplantation (NODAT) is a serious and common complication following solid organ transplantation. NODAT has been reported to occur in 2% to 53% of all solid organ transplants. Kidney transplant recipients who develop NODAT have variably been reported to be at increased risk of fatal and nonfatal cardiovascular events and other adverse outcomes including infection, reduced patient survival, graft rejection, and accelerated graft loss compared with those who do not develop diabetes. Identification of high-risk patients and implementation of measures to reduce the development of NODAT may improve long-term patient and graft outcome. The following article presents an overview of the literature on the current diagnostic criteria for NODAT, its incidence after solid organ transplantation, suggested risk factors and potential pathogenic mechanisms. The impact of NODAT on patient and allograft outcomes and suggested guidelines for early identification and management of NODAT will also be discussed.

Keywords: cyclosporine; cytomegalovirus and diabetes; hepatitis C and diabetes; new onset diabetes after transplantation (NODAT); sirolimus; tacrolimus.

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Figures

Figure 1
Figure 1
Risk factors for NODAT. Abbreviations: Anti CD25 mAb?b, Anti CD25 monoclonal antibody; CMV, cytomegalovirus; HCV, hepatitis C; HypoMg, hypomagnesemia; Pre-Tx, pre-transplant. Notes: Restoration of insulin metabolism by a functioning graft may unmask pre-transplant impaired glucose tolerance or diabetes and is not a risk factor per se. aSee text. bFurther studies are needed
Figure 2
Figure 2
Suggested pretransplant baseline evaluation of potential transplant candidates. Note: *2003 International Consensus Guidelines.
See this image and copyright information in PMC

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