Use of sodium-glucose co-transporter 2 inhibitors in solid organ transplant recipients with pre-existing type 2 or post-transplantation diabetes mellitus: A systematic review

Lin, Yolanda C.; Mok, Merisa; Harrison, Jennifer; Battistella, Marisa; Farrell, Ashley; Leung, Marianna; Cheung, Catherine

doi:10.1016/j.trre.2022.100729

Cited by 10 publications

(9 citation statements)

References 33 publications

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“…Hence, SGLT2 inhibitors' effects on solid organ transplant patients' death and other clinically relevant outcomes need more long-term RCTs. 101…”

Section: Sglt2 Inhibitors In Kidney Transplantationmentioning

confidence: 99%

Sodium-Glucose Cotransporter 2 Inhibitors' Mechanism of Action and Use in Kidney Transplantation Recipients: Extended Review and Update

Habas,

Elzouki

et al. 2024

Journal of Diabetes and Endocrine Practice

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Five sodium-glucose cotransporters (SGLTs) protein family members are important for regulating blood glucose levels. The essential cotransporters for glucose reabsorption by proximal convoluted tubule are SGLT1 and 2. The newest recommendations advocate GLT2 inhibitors as first-line treatment for type 2 diabetes (T2D) with and without chronic kidney disease (CKD), improving CKD and cardiovascular outcomes.SGLT2 inhibitors enhance kidney transplant patients' life quality, delay CKD progression, have renoprotective effects, and reduce cardiovascular disease in CKD patients, despite minimal published evidence on the usage of SGLT2 inhibitors in kidney transplantation recipients (KTxRs) with T2D or new-onset T2D. They preserve and improve renal function and cardiovascular outcomes in KTxRs. SGLT2 inhibitors' safety issues have prevented KTxRs from participating in major randomized studies, leaving doctors and patients unsure whether these extraordinary drugs outweigh the risks.This extended review analyzes the established mechanisms through which SGLT2 inhibitors exert their positive effects, evaluate the potential advantages and drawbacks of these agents in KTx, and examine the current research findings on using SGLT2 inhibitors in KTxRs. Additionally, potential avenues for future research will be suggested. Different phrases were used to search for recent original and review articles published between January 2020 and November 2023 in PubMed, Google Scholar, Scopus, EMBASE, and Google to achieve the review objectives.

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“…Hence, SGLT2 inhibitors' effects on solid organ transplant patients' death and other clinically relevant outcomes need more long-term RCTs. 101…”

Section: Sglt2 Inhibitors In Kidney Transplantationmentioning

confidence: 99%

Sodium-Glucose Cotransporter 2 Inhibitors' Mechanism of Action and Use in Kidney Transplantation Recipients: Extended Review and Update

Habas,

Elzouki

et al. 2024

Journal of Diabetes and Endocrine Practice

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“…It should be noted that one of the effects of GLP1-RAs is delayed gastric emptying, which may slow the absorption of calcineurin inhibitors and mycophenolate [74]. For SGLT-2 inhibitors, there are small studies on PTDM in patients with solid organ transplants (SOTs) suggesting their efficacy and safety [75], and a review including 2500 SOT patients demonstrated a reduction in HbA1c and weight in the short term [76]. However, attention should be paid to the potential development of urinary tract infections in these patients, and their use may not always be suitable in cases of renal insufficiency.…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Metabolic Disorders in Liver Transplant Recipients: The State of the Art

Gabrielli,

Golfieri,

Nascimbeni

et al. 2024

JCM

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Liver transplantation represents a chief therapeutic approach for acute liver failure, end-stage liver disease and hepatocellular carcinoma. Despite witnessing advancements in short- and medium-term survival over recent decades, attributed to refinements in surgical techniques and immunosuppressive protocols, long-term mortality remains impervious to modification. Notably, cardiovascular disease emerges as a predominant cause of mortality among liver transplant recipients. This trend is accentuated by the increasing prominence of non-alcoholic steatohepatitis-related cirrhosis as an indication for liver transplantation. Moreover, the administration of immunosuppressive agents is intricately linked to the degradation of the metabolic profile in liver transplant recipients, thereby contributing to the initiation or exacerbation of cardiovascular risk factors, such as hypertension, diabetes, and dyslipidaemia. In addition, the post-liver transplantation period is marked by a decline in lifestyle quality and a failure to acknowledge the psychological distress experienced by patients throughout the transplant process. These factors can precipitate a deterioration in the patient’s metabolic profile, exacerbated by suboptimal therapeutic compliance. This narrative review aims to comprehensively address the principal metabolic disorders intricately associated with liver transplantation.

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“…However, a systematic review of the use of SGLT2i in adult SOT recipients with diabetes raised concerns about urinary tract infections. 20 We must develop strategies to reduce cancer 3 and infections 21 in these patients. Prolonged and frequent exposure to healthcare settings and multiple antibiotics may predispose the transplant recipient to colonization or infection with multidrug-resistant organisms.…”

Section: Futuredirec Tionsmentioning

confidence: 99%

“…Should SGLT2i be evaluated in specific pediatric patients? However, a systematic review of the use of SGLT2i in adult SOT recipients with diabetes raised concerns about urinary tract infections 20 …”

Section: Future Directionsmentioning

confidence: 99%

The ongoing need to improve long‐term patient survival of pediatric solid organ recipients

Filler

Sharma

Ferris

2023

Pediatric Transplantation

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The ongoing need to improve long-term patient survival of pediatric solid organ recipients 1 | INTRODUC TI ON Solid organ transplantation (SOT) is the therapy of choice for endstage organ disease in children and adolescents. Due to improved immunosuppression, better management of infections and improved surgical techniques, patient survival has improved over the past decades. However, survival is limited, mostly due to cardiovascular disease, 1 infection, 2 cancer 3 and heart failure/arrhythmias (particularly for heart transplant recipients). 4 Kim and Marks reported 10year survivals in SOT patients as follows: 86.6%-92.4% for kidney (depending on donor source), 77% for liver, 58% for heart, 46% for intestines and 44% for lung (at 7 years). 5 However, we need data on longer-term outcomes, preferably country-wide or from larger jurisdictions, to develop strategies for improved patient survival. In this context, we are delighted to see the manuscript by Rebekka Salonen et al. reporting long-term mortality in Finland from 1982 to 2015. 6 4 | CON CLUS IONS Rebekka Salonen and colleagues have narrowed our knowledge gap about the long-term survival of SOT recipients and pointed to the increased risk of death compared to their peers. With interdisciplinary collaboration, comorbidities beyond the organ-specific issues need to be carefully screened to identify targets of prevention among SOT recipients. 24 AUTH O RCO NTR I B UTI O N S G Filler conceived the original study idea, provided intellectual insight, wrote the first draft, imported all the literature and edited multiple versions of the manuscript. M Ferris and A Sharma provided major intellectual insight into the manuscript as well as the manuscript writing and editing of each version.

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Use of sodium-glucose co-transporter 2 inhibitors in solid organ transplant recipients with pre-existing type 2 or post-transplantation diabetes mellitus: A systematic review

Cited by 10 publications

References 33 publications

Sodium-Glucose Cotransporter 2 Inhibitors' Mechanism of Action and Use in Kidney Transplantation Recipients: Extended Review and Update

Sodium-Glucose Cotransporter 2 Inhibitors' Mechanism of Action and Use in Kidney Transplantation Recipients: Extended Review and Update

Metabolic Disorders in Liver Transplant Recipients: The State of the Art

The ongoing need to improve long‐term patient survival of pediatric solid organ recipients

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