Transplantation Technologies & Research

The field of organ transplantation has evolved significantly since the first report of a successful kidney transplant performed by Joseph Murray at the Peter Bent Brigham Hospital in 1954. However, this relatively rapid evolution has not been without great difficulties and both clinicians and researchers have devoted significant amounts of time, dedication and resources to overcome the barriers that prevented organ transplants from becoming a widely accepted medical therapy. Throughout this process, the field has relied heavily on technological improvement for the refinement of the technical processes involved in each type of transplant. Today, transplantation is entering a new era characterized by a growing interest in novel methods for the treatment of disease that do not necessarily require transferring solid organs between patients. Areas such as islet transplantation, organ preservation, bioengineering of artificial organs, and stem cell therapies, to name a few, constitute magnificent examples of scenarios where the fusion of technology with cell transplantation biology takes place. However, this rapid expansion in research related to transplantation technology and the growing number of centers and investigators dedicated to this field has led to an increasing requirement for proper channels for the dissemination of information.

New onset diabetes mellitus after transplantation (NODAT) is a serious and common complication following solid organ transplantation. NODAT has been reported to occur in 2% to 53% of all solid organ transplants. Kidney transplant recipients who develop NODAT have variably been reported to be at increased risk of fatal and nonfatal cardiovascular events and other adverse outcomes including infection, reduced patient survival, graft rejection, and accelerated graft loss compared with those who do not develop diabetes. Limited clinical studies in liver, heart, and lung transplants similarly suggested that NODAT has an adverse impact on patient and graft outcomes. Early detection and management of NODAT must, therefore, be integrated into the treatment of transplant recipients. Studies investigating the best predictive tool for identifying patients at risk for developing NODAT early after transplantation, however, are lacking. The clinical predictive values of fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), and A1C in assessing the risk for the manifestation of NODAT are herein discussed.