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Sharif A, Hecking M, de Vries APJ, Porrini E, Hornum M, Rasoul-Rockenschaub S, Krebs G, Berlakovich M, Kautzky-Willer A, Schernthaner G, Marchetti P, Pacini G, Ojo A, Takahara S, Larsen JL, Budde K, Eller K, Pascual J, Jardine A, Bakker SJL, Valderhaug TG, Jenssen TG, Cohney S, Säemann MD. Proceedings from an international consensus meeting on posttransplantation diabetes mellitus: recommendations and future directions. Am J Transplant 2014; 14:1992-2000. [PMID: 25307034 PMCID: PMC4374739 DOI: 10.1111/ajt.12850] [Citation(s) in RCA: 339] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/21/2014] [Accepted: 05/26/2014] [Indexed: 01/25/2023]
Abstract
A consensus meeting was held in Vienna on September 8-9, 2013, to discuss diagnostic and therapeutic challenges surrounding development of diabetes mellitus after transplantation. The International Expert Panel comprised 24 transplant nephrologists, surgeons, diabetologists and clinical scientists, which met with the aim to review previous guidelines in light of emerging clinical data and research. Recommendations from the consensus discussions are provided in this article. Although the meeting was kidney-centric, reflecting the expertise present, these recommendations are likely to be relevant to other solid organ transplant recipients. Our recommendations include: terminology revision from new-onset diabetes after transplantation to posttransplantation diabetes mellitus (PTDM), exclusion of transient posttransplant hyperglycemia from PTDM diagnosis, expansion of screening strategies (incorporating postprandial glucose and HbA1c) and opinion-based guidance regarding pharmacological therapy in light of recent clinical evidence. Future research in the field was discussed with the aim of establishing collaborative working groups to address unresolved questions. These recommendations are opinion-based and intended to serve as a template for planned guidelines update, based on systematic and graded literature review, on the diagnosis and management of PTDM.
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Affiliation(s)
- A. Sharif
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK,Corresponding author: Adnan Sharif,
| | - M. Hecking
- Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
| | - A. P. J. de Vries
- Division of Nephrology and Transplant Medicine, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - E. Porrini
- Center for Biomedical Research of the Canary Islands, CIBICAN, University of La Laguna, Tenerife, Spain
| | - M. Hornum
- Department of Nephrology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | - G Krebs
- Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
| | - M. Berlakovich
- Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
| | - A. Kautzky-Willer
- Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
| | - G. Schernthaner
- Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
| | - P. Marchetti
- Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy
| | - G. Pacini
- Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy
| | - A. Ojo
- Division of Nephrology, University of Michigan Health System, Ann Arbor, MI
| | - S. Takahara
- Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Osaka, Japan
| | - J. L. Larsen
- Department of Internal Medicine, Nebraska Medical Center, Omaha, NE
| | - K. Budde
- Department of Nephrology, Charité University, Berlin, Germany
| | - K. Eller
- Clinical Division of Nephrology, Medical University of Graz, Graz, Austria
| | - J. Pascual
- Servicio de Nefrología, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - A. Jardine
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - S. J. L. Bakker
- Department of Internal Medicine, University Medical Center Groningen and University of Groningen, Groningen, the Netherlands
| | - T. G. Valderhaug
- Department of Endocrinology, Akershus University Hospital, Lorenskog, Norway
| | - T. G. Jenssen
- Department of Organ Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - S. Cohney
- Department of Nephrology, Royal Melbourne and Western Hospitals, Melbourne, Australia
| | - M. D. Säemann
- Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
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