Early worsening of diabetic retinopathy after simultaneous pancreas and kidney transplantation—Myth or reality?

Voglová, Barbora; Hladíková, Zuzana; Nemétová, Lenka; Zahradnicka, Martina; Kesslerova, Katerina; Sosna, T; Lipar, K.; Koznarová, R; Girman, Peter; Saudek, František

doi:10.1111/ajt.15924

Cited by 10 publications

(9 citation statements)

References 50 publications

(108 reference statements)

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“…Researchers do not dispute the importance of metabolic control in pancreatic transplant candidates, but they do not associate ocular changes after transplantation with differences in diabetes control before and after surgery. Normoglycaemia achieved as a result of surgery has a positive impact on the further course of previously diagnosed DR, which may result in its stabilization or improvement [133].…”

Section: Pancreatic Islet Transplantationmentioning

confidence: 99%

The Safety of Pharmacological and Surgical Treatment of Diabetes in Patients with Diabetic Retinopathy—A Review

Matuszewski

Baranowska-Jurkun

Stefanowicz-Rutkowska

et al. 2021

JCM

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Background. Diabetes mellitus (DM) is a non-infectious pandemic of the modern world; it is estimated that in 2045 it will affect 10% of the world’s population. As the prevalence of diabetes increases, the problem of its complications, including diabetic retinopathy (DR), grows. DR is a highly specific neurovascular complication of diabetes that occurs in more than one third of DM patients and accounts for 80% of complete vision loss cases in the diabetic population. We are currently witnessing many groundbreaking studies on new pharmacological and surgical methods of treating diabetes. Aim. The aim of the study is to assess the safety of pharmacological and surgical treatment of DM in patients with DR. Material and methods. An analysis of the data on diabetes treatment methods currently available in the world literature and their impact on the occurrence and progression of DR. Results. A rapid decrease in glycaemia leads to an increased occurrence and progression of DR. Its greatest risk accompanies insulin therapy and sulfonylurea therapy. The lowest risk of DR occurs with the use of SGLT2 inhibitors; the use of DPP-4 inhibitors and GLP-1 analogues is also safe. Patients undergoing pancreatic islet transplants or bariatric surgeries require intensive monitoring of the state of the eye, both in the perioperative and postoperative period. Conclusions. It is of utmost importance to individualize therapy in diabetic patients, in order to gradually achieve treatment goals with the use of safe methods and minimize the risk of development and progression of DR.

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Section: Pancreatic Islet Transplantationmentioning

confidence: 99%

The Safety of Pharmacological and Surgical Treatment of Diabetes in Patients with Diabetic Retinopathy—A Review

Matuszewski

Baranowska-Jurkun

Stefanowicz-Rutkowska

et al. 2021

JCM

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“…A study looking at DR after combined kidney-pancreas transplantation showed early worsening (defined as 2.3 years following transplantation), characterized by vitreous hemorrhages and increased risk of cataract [183]. More recently, a sub-analysis of 43 patients from the ongoing randomized clinical study EMA-SPK, which will evaluate the differences in retinal neovascularization in patients with DR, has shown that 16 patients (37.2%) developed an early worsening of diabetic retinopathy within 12 months following a pancreas and kidney (PAK) transplant [184]. Several theories exist explaining why retinopathy may not remain stable following a pancreas transplant.…”

Section: Systemic Treatment Of Diabetic Retinopathy and Islet Cell Transplantationmentioning

confidence: 99%

Recent Advancements in the Medical Treatment of Diabetic Retinal Disease

Szymańska

Mahmood

Yap

et al. 2021

IJMS

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Diabetic retinal disease remains one of the most common complications of diabetes mellitus (DM) and a leading cause of preventable blindness. The mainstay of management involves glycemic control, intravitreal, and laser therapy. However, intravitreal therapy commonly requires frequent hospital visits and some patients fail to achieve a significant improvement in vision. Novel and long-acting therapies targeting a range of pathways are warranted, while evidence to support optimal combinations of treatments is currently insufficient. Improved understanding of the molecular pathways involved in pathogenesis is driving the development of therapeutic agents not only targeting visible microvascular disease and metabolic derangements, but also inflammation and accelerated retinal neurodegeneration. This review summarizes the current and emerging treatments of diabetic retinal diseases and provides an insight into the future of managing this important condition.

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“…El TP funcionante previene o reduce la nefropatía (41), mejora la polineuropatía periférica y autonómica (cardiaca, digestiva) (42) y mejora la enfermedad cardio-cerebro-vascular (43), aumenta el colesterol HDL y disminuye el colesterol LDL y la tensión arterial (44). Asimismo, la retinopatía se estabiliza o mejora a los 3 años del trasplante entre el 63% y 73% de los pacientes (45,46).…”

Section: Cuidados Perioperatorios Y Monitorización Del Injerto C0mplicaciones Pos-trasplanteunclassified

Update of pancreas transplantation. Experience of the Hospital Doce de Octubre

Jiménez¹,

Moreno²,

Manrique³

et al. 2021

an. ranm

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Pancreas transplantation (PT) is considered as the only treatment that can convert a diabetic patient in a euglucemic state without the use of insulin or oral antidiabetic drugs. From 1996 to the end of 2016, more than 50,000 PT were performed in USA, and in Spain were performed 1.730 PT during the last 10 years. In this review we will perform an update of PT considering the introduction of several advances in the last years, adding our accumulated experience from the beginning of our program in the year 1995. The first PT was carried out in the Hospital of the University of Minnesota, and from that date several significant improvements have been introduced along the time due to advances in surgical technique in pancreas donors and recipients, perioperative management of patients, and introduction of more potent immunosuppressors able to reduce the rejection rate under 20%. Although PT is a therapy associated with a higher morbidity (pancreas graft thrombosis, systemic and intraabdominal infections, anastomotic leakages, etc.), currently most of the PT teams have obtained a rate of 93% of patient survival at 3-years, and between 78% and 83% of graft survival at 3-years. Additionally, the normal pancreas graft function is associated with an improvement of quality of life and most of complications related to diabetes, without the necessity to treat with antidiabetics drugs or insulin.

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Early worsening of diabetic retinopathy after simultaneous pancreas and kidney transplantation—Myth or reality?

Cited by 10 publications

References 50 publications

The Safety of Pharmacological and Surgical Treatment of Diabetes in Patients with Diabetic Retinopathy—A Review

The Safety of Pharmacological and Surgical Treatment of Diabetes in Patients with Diabetic Retinopathy—A Review

Recent Advancements in the Medical Treatment of Diabetic Retinal Disease

Update of pancreas transplantation. Experience of the Hospital Doce de Octubre

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