Zolota A, Miserlis G, Solonaki F, Tranda A, Antoniadis N, Imvrios G, Fouzas I
Surgery Clinic of Transplantation, Aristotle University of Thessaloniki, Ippokrateio General Hospital, Thessaloniki, Greece.
Surgery Clinic of Transplantation, Aristotle University of Thessaloniki, Ippokrateio General Hospital, Thessaloniki, Greece.
Transplant Proc. 2018 Dec;50(10):3386-3391. doi: 10.1016/j.transproceed.2018.08.037. Epub 2018 Sep 7.
New-onset diabetes after transplantation (NODAT) is a complication of renal transplantation (RT) with an adverse effect on graft survival.
The purpose of the present study was to compare modifiable or non-modifiable clinical and laboratory parameters as well as the course of patients and transplants between 2 groups of RT recipients with NODAT in relation to the use of either a cyclosporine-based (group A) or a tacrolimus-based immunosuppressive regimen (group B).
Retrospectively comparing 66 renal transplant recipients with NODAT, multiple clinical, and laboratory parameters were investigated. For statistical analysis, the χ test, the Student t test, and the patient and graft survival or the Kaplan-Meier analysis from the statistical software SPSS 22.0 for Windows were used.
There was no statistically significant difference in association with the majority of the investigated parameters. In group B (tacrolimus [Tac]), more patients had HbA1c >7.2% at 3 years after RT. The mean value of systolic blood pressure was higher in group A (cyclosporine [CsA]) at 6 months and at 1 year after RT. More patients in group A (CsA) experienced at least one acute rejection episode. Finally, greater levels of cold ischemia time were recorded in group B (Tac) and statistically significant difference was found in connection with the patient and graft survival in the fourth year after RT.
NODAT in patients on tacrolimus requires the adjustment of modifiable clinical and metabolic parameters and possible change of the immunosuppressive regimen to a cyclosporine-based one.
移植后新发糖尿病（NODAT）是肾移植（RT）的一种并发症，对移植肾存活有不良影响。
本研究的目的是比较两组发生NODAT的肾移植受者在使用基于环孢素（A组）或他克莫司的免疫抑制方案（B组）方面可改变或不可改变的临床和实验室参数，以及患者和移植肾的病程。
回顾性比较66例发生NODAT的肾移植受者，研究多个临床和实验室参数。为进行统计分析，使用了χ检验、学生t检验，以及来自Windows版统计软件SPSS 22.0的患者和移植肾存活情况或Kaplan-Meier分析。
与大多数研究参数相关的差异无统计学意义。在B组（他克莫司[Tac]）中，更多患者在肾移植后3年时糖化血红蛋白（HbA1c）>7.2%。在肾移植后6个月和1年时，A组（环孢素[CsA]）的收缩压平均值较高。A组（CsA）更多患者经历了至少一次急性排斥反应。最后，B组（Tac）记录到更长的冷缺血时间，并且在肾移植后第四年患者和移植肾存活方面发现有统计学意义的差异。
接受他克莫司治疗的患者发生NODAT时，需要调整可改变的临床和代谢参数，并可能将免疫抑制方案改为基于环孢素的方案。
