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Post-transplant diabetes mellitus following heart transplantation

Joshua D Newman1, Kelly H Schlendorf1, Zachary L Cox2

  • 1Division of Cardiology, Section of Heart Failure and Cardiac Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|August 15, 2022
PubMed

Insights

Post-transplant diabetes mellitus (PTDM) affects over 20% of heart transplant recipients, often within the first year. PTDM increases infection, kidney failure, and mortality risks, necessitating tailored management strategies.

Area of Science:

  • Cardiology
  • Endocrinology
  • Transplantation

Background:

  • Post-transplant diabetes mellitus (PTDM) is a frequent complication after heart transplantation, affecting over 20% of patients.
  • PTDM significantly elevates risks for post-operative infections, renal failure, and mortality, impacting long-term patient outcomes.

Approach:

  • This review synthesizes current knowledge on PTDM definitions, incidence, and unique risk factors.
  • It examines the pathophysiology, emphasizing the role of immunosuppressive medications in hyperglycemia.
  • The review discusses emerging therapeutic options and pharmacologic considerations for PTDM management.

Key Points:

  • PTDM presents distinct risk factors and pathophysiological mechanisms compared to pre-transplant diabetes.
  • Immunosuppressive agents are critical contributors to PTDM development.
  • Novel antihyperglycemic agents show promise in addressing PTDM.

Conclusions:

  • Effective PTDM management is crucial for improving heart transplant recipient survival and quality of life.
  • Further research is needed to optimize treatment strategies and understand long-term PTDM trajectories.

Keywords:
GLP-1 receptor agonistsSGLT-2 inhibitorsheart transplantationimmunosuppressionpost-transplant diabetes mellitus

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