Abstract
Heart transplantation is today the gold standart of treatment of an end-stage of a heart failure.
As one of the main complications in the early postoperative period after transplantation of heart the post-transplant diabetes
mellitus is recognized. Despite that prevalence of this complication was reduced, in connection with decrease of doses of
steroids in the postoperative period, the post-transplant diabetes mellitus is still widespread among patients after a heart transplantation.
The post-transplant diabetes mellitus is independent risk factor of a graft rejection, cardiovascular diseases and death
after transplantation of a liver and kidneys. However a small amount of researches on identification of predictors of development
of a post-transplant diabetes mellitus after heart transplantation is carried out. Some researches put in the forefront the
enlarged risk of a post-transplant infection, a casting-off, illnesses of coronary arteries of the transplanted heart, a renal failure
and a lethality among recipients with a diabetes mellitus. On base to data of the international society on a heart transplantation
and mild (ISHLT-International Society for Heart and Lung Transplantation) among patients with a diabetes mellitus the lethality
is enlarged by 20-40 %. However, results are sometimes inconsistent, and some authors didn't find essential differences on
survival among patients with and without a diabetes mellitus. On the other hand the immunosupressin therapy which is using
in the post-transplant period, worsens a pretransplant diabetes mellitus and enlarges risk of development of a post-transplant
diabetes mellitus.
References
1. Бокерия, Л.А., Ревишвили А.Ш., Рзаев Ф.Х., Ломидзе Н.Н. Застойная сердечная недостаточность: применение медикаментозной терапии,
электрокардиостимуляторов или имплантируемых кардиовертеров-дефибрилляторов. Анналы аритмологии. 2006; 1: 27–33.
2. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2011; 34: S62–9.
3. American Diabetes Association. Standards of medical care in diabetes: 2011. Diabetes Care. 2011; 34: S11–61.
4. Gosmanov A.R., Dagogo-Jack S. Predicting, managing and preventing new-onset diabetes after transplantation. Minerva Endocrinol. 2012; 37 (3):
233–46.
5. Taylor D.O., Stehlik J., Edwards L.B. et al. Registry of the International Society for Heart and Lung Transplantation: Twenty-sixth Official Adult
Heart Transplant Report-2009. J. Heart Lung Transplant. 2009; 28: 1007–22.
6. António N., Prieto D., Provide^ncia L.A., Antunes M.J. Diabetes mellitus does not affect one-year outcome after heart transplantation. Rev. Port.
Cardiol. 2010; 29: 205–20.
7. Saraiva J., Sola E., Prieto D., Antunes M. Diabetes as an outcome predictor after heart transplantation. Interact. Cardiovasc. Thorac. Surg. 2011; 13:
499–504.
8. Vincenti F., Friman S., Scheuermann E. et al. Results of an international, randomized trial comparing glucose metabolism disorders and outcome
with cyclosporine versus tacrolimus. Am. J. Transplant. 2007; 7: 1506–14.
9. Ye X., Kuo H.T., Sampaio M.S. et al. Risk factors for development of new-onset diabetes mellitus after transplant in adult lung transplant recipients.
Clin. Transplant. 2011; 25: 85–91.
10. Kuo H.T., Lau C., Sampaio M.S. et al. Pretransplant risk factors for new-onset diabetes mellitus after transplant in pediatric liver transplant recipients.
Liver Transplant. 2010; 16: 1249–56.
11. Russo M.J., Chen J.M., Hong K.N. et al. Survival after heart transplantation is not diminished among recipients with uncomplicated diabetes mellitus:
an analysis of the United Network of Organ Sharing database. Circulation. 2006; 114: 2280–7.
12. Cho M.S., Choi H.I., Kim I.O., Jung S.H. et al. The clinical course and outcomes of post-transplantation diabetes mellitus after heart transplantation.
J. Korean Med. Sci. 2012; 27: 1460–7.
13. Pham P.T., Pham P.C., Lipshutz G.E. et al. New Onset diabetes mellitus after solid organ transplantation. Endocrinol. Metab. Clin. N. Am. 2007; 36:
873–90
14. Bodziak K.A, Hricik D.E. New-onset diabetes mellitus after solid organ transplantation. Transplant. Int. 2009; 22: 519–30.
15. Hjelmesaeth J., Hartmann A., Leivestad T. et al. The impact of early-diagnosed new-onset post-transplantation diabetes mellitus on survival and
major cardiac events. Kidney Int. 2006; 69: 588–95.
16. Valantine H., Rickenbaker P., Kemna M. et al. Metabolic abnormalities characteristic of dysmetabolic syndrome predict the development of transplant
coronary artery disease. Circulation. 2001; 103: 2144–52.
17. Hampton T. Diabetes drugs tied to fractures in women. JAMA. 2007; 297: 1645–7.
18. Marasco S.F., Esmore D.S., Richardson M. et al. Prolonged cardiac allograft ischemic time: no impact on long-term survival but at what cost? Clin.
Transplant. 2007; 21: 321–9.
19. Mehra M.R., Crespo-Leiro M.G., Dipchand A. et al. International Society for Heart and Lung Transplantation working formulation of a standardized
nomenclature for cardiac allograft vasculopathy-2010. J. Heart Lung Transplant. 2010; 29: 717–27.
20. Higgins J., Pflugfelder P.W., Kostuk W.J. Increased morbidity in diabetic cardiac transplant recipients. J. Cardiol. 2009; 25: 125–9.
21. Jimenez M., Marquez S., Munoz A. et al. Incidence and importance of de novo diabetes mellitus after heart transplantation. Transplant. Proc. 2008;
40: 3053–5.
22. John P.R., Thuluvath P.J. Outcome of patients with new-onset diabetes mellitus after liver transplantation compared with those without diabetes mellitus.
Liver Transplant. 2002; 8: 708–13.
23. Shah P., Probach J., Veglahn T. Posttransplantation Diabetes Mellitus. Endocrinology. 2009; 7 (4): 2.
24. Rylski B., Berchtold-Herz M., Olschewski M. et al. Reducing the ischemic time of donor hearts will decrease morbidity and costs of cardiac transplantations.
Interact. Cardiovasc. Thorac. Surg. 2010; 10: 945–7.
