Au cours de ce travail, nous nous sommes intéressés à l'impact de l'exposition à la ciclosporine A (CsA) sur la signalisation angiogénique dans le carcinome à cellules rénales (renal cell carcinoma – RCC) qui représente la deuxième cause de cancer chez les patients transplantés rénaux. Nous avons examiné in vitro l'impact de l'exposition à la CsA sur la réponse UPR (Unfolded Protein Response) et la régulation des protéines sécrétées en portant un intérêt particulier à la régulation du VEGF (Vascular Endothelial Growth factor). Nous confirmons l'effet de la CsA sur la protéostase et montrons que l'activation de l'UPR par la CsA, conduisant à une augmentation de la production de VEGF en hypoxie, pourrait participer à l'agressivité des tumeurs. Nous proposons de rechercher certains biomarqueurs de l'UPR chez les patients ayant développé un RCC post-transplantation afin d'examiner de façon plus approfondie l'altération de la protéostase et la régulation de l'UPR dans ce contexte. Dans le domaine de la médecine personnalisée, d'autres approches comme la pharmacogénétique sont désormais utilisées dans la pratique médicale. Dans ce contexte, nous avons évalué l'intérêt du génotypage du VEGF dans une cohorte de patients transplantés rénaux. Nous montrons que le polymorphisme VEGF 936 C>T est associé de façon significative au risque de développer un RCC post-transplantation. Même s'il est évident que des études supplémentaires doivent être menées, nos résultats indiquent que le génotypage de VEGF 936 C>T pourrait être envisagé pour améliorer la gestion des traitements immunosuppresseurs chez les patients identifiés comme étant à risque de développer un RCC post-transplantation / In this work, we investigated the impact of cyclosporine A (CsA) exposure on angiogenic signalling in renal cell carcinoma (RCC), the second mostly observed cancer in renal transplanted patients. We examined in vitro the effect of CsA exposure on the Unfolded Protein Response (UPR) and the regulation of secreted proteins with a focus on VEGF (Vascular Endothelial Growth Factor) regulation. We confirm the effect of CsA on proteostasis and we show that the activation of UPR by CsA, leading to an increased VEGF hypoxic expression, could contribute to the aggressiveness of tumours. We propose to investigate a list of candidate UPR biomarkers in patients who have developed a post-transplant RCC in order to confirm the alteration of proteostasis and the UPR activation in this context. In the field of personalized medicine, other approaches such as pharmacogenetics are now used in medical practice. In this context, we evaluated the VEGF genotyping in a cohort of renal transplanted patients. We show that VEGF 936 C>T is significantly associated with the risk of developing a post-transplant RCC. Although it is evident that additional studies need to be conducted, our results indicate that VEGF 936 C>T genotypes might be useful to classify patients according to their post-transplant RCC risk in order to improve immunosuppressive drugs management

The discovery of new immunosuppressive drugs has resulted in an improvement of short-term graft survival. Despite this achievement, long-term cardiac allograft survival has not been correspondingly improved. Cyclosporine A (CsA), an effective immunosuppressive drug, has been shown to increase the risk of hyperlipidemia, hypertension, kidney injuries and chronic rejection despite its extensive use in the clinical setting. Therefore, these side-effects of CsA, may further contribute to graft failure over long-term. Early studies have shown that fish oil may reduce side-effects of CsA. These beneficial effects of fish oil may be related to n-3 fatty acids (n-3 FAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Flaxseed oil is another major source of an n-3 FA, namely α-linolenic acid (ALA). However, its impact on heart transplantation has not been fully explored. The current study aimed to investigate whether dietary flaxseed oil and fish oil reduce post-transplant complications and prolong graft function in a rat cardiac allograft model. Male Fischer and Lewis rats were used as donors and recipients, respectively, to generate a heterotopic cardiac allograft model. After transplant, animals were randomly assigned into 3 groups and fed a diet supplemented with: a) 5% w/w safflower oil (control n=7), b) 5% w/w flaxseed oil (n=8) or c) 2% w/w fish oil (n=7) and an intraperitoneal injection of cyclosporine A (CsA) (1.5 mg/kg/d) over 12 weeks. Body weight, blood pressure (BP), plasma levels of lipids, CsA, and select cytokines, fatty acid profile of hearts (native and graft) and liver tissues as well as graft function and chronic rejection features were assessed. Body weight and blood CsA levels were similar among the groups. As compared to controls, both diet treated groups demonstrated a significantly lower systolic blood pressure (SBP) (p<0.001), diastolic blood pressure (pressure (DBP) (p<0.001), mean arterial pressure (MAP) (p<0.001), heart rate (p<0.05), abdominal fat (p<0.05) and plasma levels of macrophage chemoattractant protein-1 (MCP-1) (p<0.05). Moreover, the fish oil group had significantly (p<0.05) lower plasma levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL), as compared to the control group. High-density lipoprotein cholesterol (HDL) concentrations were significantly higher (P<0.05) in the flaxseed oil-treated group as compared to the other two groups. Data of this study suggest that both flaxseed oil and fish oil may provide similar biochemical, hemodynamic and inflammatory improvements after heart transplantation; however, these apparent beneficial changes were not accompanied with significant reductions in chronic rejection states or apparent histological evidence of cyclosporine-induced nephrotoxicity in this model.

The discovery of new immunosuppressive drugs has resulted in an improvement of short-term graft survival. Despite this achievement, long-term cardiac allograft survival has not been correspondingly improved. Cyclosporine A (CsA), an effective immunosuppressive drug, has been shown to increase the risk of hyperlipidemia, hypertension, kidney injuries and chronic rejection despite its extensive use in the clinical setting. Therefore, these side-effects of CsA, may further contribute to graft failure over long-term. Early studies have shown that fish oil may reduce side-effects of CsA. These beneficial effects of fish oil may be related to n-3 fatty acids (n-3 FAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Flaxseed oil is another major source of an n-3 FA, namely α-linolenic acid (ALA). However, its impact on heart transplantation has not been fully explored. The current study aimed to investigate whether dietary flaxseed oil and fish oil reduce post-transplant complications and prolong graft function in a rat cardiac allograft model. Male Fischer and Lewis rats were used as donors and recipients, respectively, to generate a heterotopic cardiac allograft model. After transplant, animals were randomly assigned into 3 groups and fed a diet supplemented with: a) 5% w/w safflower oil (control n=7), b) 5% w/w flaxseed oil (n=8) or c) 2% w/w fish oil (n=7) and an intraperitoneal injection of cyclosporine A (CsA) (1.5 mg/kg/d) over 12 weeks. Body weight, blood pressure (BP), plasma levels of lipids, CsA, and select cytokines, fatty acid profile of hearts (native and graft) and liver tissues as well as graft function and chronic rejection features were assessed. Body weight and blood CsA levels were similar among the groups. As compared to controls, both diet treated groups demonstrated a significantly lower systolic blood pressure (SBP) (p<0.001), diastolic blood pressure (pressure (DBP) (p<0.001), mean arterial pressure (MAP) (p<0.001), heart rate (p<0.05), abdominal fat (p<0.05) and plasma levels of macrophage chemoattractant protein-1 (MCP-1) (p<0.05). Moreover, the fish oil group had significantly (p<0.05) lower plasma levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL), as compared to the control group. High-density lipoprotein cholesterol (HDL) concentrations were significantly higher (P<0.05) in the flaxseed oil-treated group as compared to the other two groups. Data of this study suggest that both flaxseed oil and fish oil may provide similar biochemical, hemodynamic and inflammatory improvements after heart transplantation; however, these apparent beneficial changes were not accompanied with significant reductions in chronic rejection states or apparent histological evidence of cyclosporine-induced nephrotoxicity in this model.

Class of 2015 Abstract / Objectives: To assess the efficacy of fluconazole prophylaxis in the prevention of coccidioidomycosis in the post-heart transplant patient and to identify risk factors for coccidioidomycosis infection. Methods: Heart transplant patients with ICD-9 code V42.1 from October 2001 to October 2013, were selected and electronic medical records were retrospectively reviewed for coccidioidomycosis history, Coccidiodes serologies, reason for transplantation, immunosuppressive drug therapy regimens, rejection treatment course, fluconazole dose, and demographics. Negative Coccidiodes serology results post transplantation relative to negative Coccidiodes serology results prior to transplantation will be determined using a Chi Square test. Risk factors for disease contraction will be analyzed using multivariate logistic regression. Results: Between October 2001 and October 2013, 244 patients received a heart transplant at this institution. Fourteen (5.7%) heart transplant recipients with a negative Coccidiodes serology pre-transplantation had a positive Coccidiodes serology post-transplantation. Nine (64.2%) of those recipients received antifungal prophylaxis (p=0.16). Risk factors for developing a positive Coccidiodes serology included using tacrolimus (p=0.05) and non-ischemic cardiomyopathy (p=0.04). Conclusions: Antifungal prophylaxis does not reduce the risk of developing a positive Coccidiodes serology after heart transplantation. Risk factors for developing a positive Coccidiodes serology include the use of tacrolimus and having non-ischemic cardiomyopathy prior to transplant.

The targeted transplant center's abdominal organ transplant unit had difficulty providing adequate education to patients prior to discharge, which had resulted in a 24% readmission rate within 30 days due to infections. Patients and caregivers were unavailable to receive education despite multiple attempts, which made it challenging for health care providers to complete this aspect of their job, resulting in a negative impact on patients' long-term outcomes. A more structured educational environment was needed to provide appropriate and effective patient and caregiver education to increase adherence and positive outcomes. The health promotion model served as a foundation for the development of the evidence-based educational process and materials. A panel of 6 experts was invited to review the evidence-based, theory-supported educational materials along with the staff and caregiver educational process developed for the unit. Five experts participated in the formative and summative evaluation of the educational process, materials, and the evaluation tool. Results of the evaluations demonstrated that a majority (83%) of the experts found the educational materials and process were essential, accurate, and provided a more structured environment that afforded health care providers the ability to maintain compliance with the targeted transplant center's education policy. The materials, process, and evaluation tool will be implemented at the site. Social change will result from increased patient engagement and confidence in self-care; improved caregiver ability to assist the patient; and reduced risk of noncompliance, readmissions, and poor outcomes.

No description available.

Background: When a person suffers from organ failure, an organ transplantation can save life. Persons on the waiting list often have mixed feelings like uncertainty and hope for the future. Even the time after transplantation is described like a period of physical and mental challenges during the recovering. Aim: The aim of this study was to highlight persons´ experiences after an organ transplantation. Method: The method used was a literature-based study based on qualitative articles. A total of eight articles were analyzed with a Qualitative content analysis. Results: The results from the study showed that people experienced mixed feelings after transplantation and these were described in three main themes: A new reality, New strategies and Emotional roller coaster. Conclusion: People who have undergone an organ transplant experience both physical and mental stress during recovery. / Personer som drabbas av svikt i ett eller flera organ kan bli aktuella för en organtransplantation. Det är en medicinsk behandlingsmetod som kan rädda liv men samtidigt innebära många omställningar i personens liv. När personerna stod på väntelistan för organtransplantation hade de olika tankar inför sin kommande transplantation och förhoppningar inför livet som transplanterade. Studiens syfte var att belysa personers upplevelser av att ha genomgått en organtransplantation. Åtta artiklar valdes sammanlagt till studien. I resultatet framkom att personerna upplevde fysiska och psykiska påfrestningar efter operationen. Utifrån det formades tre teman En ny verklighet, Nya strategier och Känslomässig bergodalbana. Upplevelserna efter transplantationen hade både positiv och negativ karaktär. Personerna kände skuld, rädsla, tacksamhet och tillit över att ha mottagit ett organ från en avliden person. Chansen till ett nytt liv var något som många ville förvalta på bästa sätt. Personerna upplevde även förändrade roller i familjen och med vänner. De kunde återuppta sina intressen och sina roller som make/maka, förälder och vän. Personerna upplevde även begränsningar i sitt nya liv genom restriktioner i form av infektionskänslighet och medicinering. De flesta fick hjälp och stöttning från familj och upplevde att det och adekvat information från sjukvården gav dem trygghet i sitt tillfrisknande. Sjuksköterskan har en betydande roll i omhändertagandet av personer som genomgått en organtransplantation. Det framkom att många negativa upplevelser som personerna genomgick hade kunnat förhindras med hjälp av information. Genom ett personcentrerat förhållningssätt där varje person bemöts utefter deras förutsättningar och behov går det att förbättra omhändertagandet av personer som genomgått en transplantation och minska deras negativa upplevelser.

Introdução: Diabete Melito Pós-Transplante (DMPT) é considerado uma séria complicação do transplante de rim, podendo diminuir a sobrevida do enxerto e do paciente. O imunossupressor tacrolimo (TAC) pode aumentar o risco de desenvolvimento de DMPT. Objetivos: Estimar o risco de DMPT em pacientes tratados com TAC no Serviço de Transplante Renal da Irmandade da Santa Casa de Misericórdia de Porto Alegre, identificar os demais fatores de risco para o DMPT e suas conseqüências. Métodos: Foram analisados 413 pacientes sem diabetes prévia ao transplante, com 18 anos ou mais, tratados com TAC, ciclosporina (CsA) ou sirolimo (SIR), em uso de corticoterapia e com período de seguimento póstransplante maior de 6 meses. O estudo seguiu o modelo observacional–coorte retrospectivo. Os critérios da Associação Americana de Diabete foram utilizados para o diagnóstico de DMPT. Os dados foram coletados de prontuários. Resultados: Dos 413 pacientes analisados, 171(41,4%) receberam como imunossupressão inicial TAC, 221(53,5%) CsA e 21(5,1%) SIR. DMPT ocorreu em 20,6% dos pacientes da coorte (85 de 413). A mediana do tempo para o desenvolvimento de DMPT foi de 54 dias. A incidência cumulativa de DMPT foi de 24,6% e 17,2% para os grupos de tratamento TAC e CsA, respectivamente. Na análise por intenção de tratamento, o risco para o desenvolvimento de DMPT, ao comparar os grupos TAC vs. CsA foi de HR=1,563, (IC:95%=1,008–2,425), P=0,006. Pelo método de Kaplan-Meier, 78,9% dos pacientes em uso de TAC estavam livres de DMPT no mês 6 vs. 87,8% dos pacientes em uso de CsA (P= 0,044). Os demais fatores de risco independentes identificados foram: índice de massa corporal (IMC) pré-transplante (P<0,0001), idade do receptor (P<0,0001) e episódio de rejeição aguda (RA) (P=0,013). Não houve diferença estatística significativa para anti-HCV reagente do receptor. Em 3 anos, a sobrevida do enxerto, ao comparar os pacientes com diagnóstico de DMPT vs. ausência de DMPT foi de 85,5% e 93,3%, respectivamente (P=0,021) e a sobrevida do paciente foi de 88,9% e 96,7%, respectivamente (P=0,017). Conclusão: A incidência de DMPT está associada com o tipo de imunossupressão utilizada, idade do receptor, IMC pré-transplante e episódio de RA. DMPT é um importante fator de risco para perda do enxerto e mortalidade. Medidas para minimizar o risco dessa complicação devem ser tomadas, como a individualização da terapia imunossupressora. / Introduction: Post-transplant diabetes mellitus (PTDM) is considered a serious complication of kidney transplantation and may reduce the patient and graft survival. The immunosuppressive Tacrolimus (TAC) may increase the risk of developing PTDM. Purpose: To estimate the risk of PTDM in renal transplant recipients treated with TAC in our center, identify all risk factors for PTDM and its consequences. Methodology: We analyzed 413 patients without diabetes prior to transplantation, with age ≥ 18 years, who were treated with tacrolimus (TAC), cyclosporine (CyA) or sirolimus (SIR), under steroids therapy and with a follow-up post-transplant period more than 6 months. We performed a retrospective review – cohort study. PTDM was diagnosed according to American Diabetes Association guidelines. Data were collected from medical records. Results: We examined 413 renal allograft recipients, these, 171 (41.4%) received initial immunosuppresion with TAC, 221 (53.5%) CyA and 21 (5.1%) SIR. PTDM occurred in 20.6% of patients in the cohort (85 of 413). The median time to the development of PTDM was 54 days post transplant. The cumulative incidence of PTDM was 24.6% and 17.2% for groups TAC and CyA treatment, respectively. In the analysis by intention to treat, the proportion of patients receiving TAC who developed PTDM was significantly higher than patients receiving CyA (HR=1,563, (CI:95%=1,008–2,425), P=0,006. The Kaplan-Meier method showed that 78,9% patients taking TAC were free of PTDM at six months compared to 87,8% of patients taking CsA (P= 0.044). The other independent risk factors identified were: body mass index (BMI) (P<0,0001), recipient age (P<0,0001) and acute rejections episodes (AR) (P=0,013). There was no statistically significant difference for patients with hepatitis C. Three years actuarial graft survival was 85,5% in patients with PTDM compared with 93,3% for those without diabetes (P=0,021) and patient survival was 88,9% e 96,7%, respectively (P=0,017). Conclusions: The incidence of PTDM is associated with TAC use, the recipient age, BMI and acute rejections episodes. PTDM is an important risk factor for graft loss and mortality. Measures to minimize the risk of this complication should be taken, such as the individualization of immunosuppresive therapy.

Introdução: Diabete Melito Pós-Transplante (DMPT) é considerado uma séria complicação do transplante de rim, podendo diminuir a sobrevida do enxerto e do paciente. O imunossupressor tacrolimo (TAC) pode aumentar o risco de desenvolvimento de DMPT. Objetivos: Estimar o risco de DMPT em pacientes tratados com TAC no Serviço de Transplante Renal da Irmandade da Santa Casa de Misericórdia de Porto Alegre, identificar os demais fatores de risco para o DMPT e suas conseqüências. Métodos: Foram analisados 413 pacientes sem diabetes prévia ao transplante, com 18 anos ou mais, tratados com TAC, ciclosporina (CsA) ou sirolimo (SIR), em uso de corticoterapia e com período de seguimento póstransplante maior de 6 meses. O estudo seguiu o modelo observacional–coorte retrospectivo. Os critérios da Associação Americana de Diabete foram utilizados para o diagnóstico de DMPT. Os dados foram coletados de prontuários. Resultados: Dos 413 pacientes analisados, 171(41,4%) receberam como imunossupressão inicial TAC, 221(53,5%) CsA e 21(5,1%) SIR. DMPT ocorreu em 20,6% dos pacientes da coorte (85 de 413). A mediana do tempo para o desenvolvimento de DMPT foi de 54 dias. A incidência cumulativa de DMPT foi de 24,6% e 17,2% para os grupos de tratamento TAC e CsA, respectivamente. Na análise por intenção de tratamento, o risco para o desenvolvimento de DMPT, ao comparar os grupos TAC vs. CsA foi de HR=1,563, (IC:95%=1,008–2,425), P=0,006. Pelo método de Kaplan-Meier, 78,9% dos pacientes em uso de TAC estavam livres de DMPT no mês 6 vs. 87,8% dos pacientes em uso de CsA (P= 0,044). Os demais fatores de risco independentes identificados foram: índice de massa corporal (IMC) pré-transplante (P<0,0001), idade do receptor (P<0,0001) e episódio de rejeição aguda (RA) (P=0,013). Não houve diferença estatística significativa para anti-HCV reagente do receptor. Em 3 anos, a sobrevida do enxerto, ao comparar os pacientes com diagnóstico de DMPT vs. ausência de DMPT foi de 85,5% e 93,3%, respectivamente (P=0,021) e a sobrevida do paciente foi de 88,9% e 96,7%, respectivamente (P=0,017). Conclusão: A incidência de DMPT está associada com o tipo de imunossupressão utilizada, idade do receptor, IMC pré-transplante e episódio de RA. DMPT é um importante fator de risco para perda do enxerto e mortalidade. Medidas para minimizar o risco dessa complicação devem ser tomadas, como a individualização da terapia imunossupressora. / Introduction: Post-transplant diabetes mellitus (PTDM) is considered a serious complication of kidney transplantation and may reduce the patient and graft survival. The immunosuppressive Tacrolimus (TAC) may increase the risk of developing PTDM. Purpose: To estimate the risk of PTDM in renal transplant recipients treated with TAC in our center, identify all risk factors for PTDM and its consequences. Methodology: We analyzed 413 patients without diabetes prior to transplantation, with age ≥ 18 years, who were treated with tacrolimus (TAC), cyclosporine (CyA) or sirolimus (SIR), under steroids therapy and with a follow-up post-transplant period more than 6 months. We performed a retrospective review – cohort study. PTDM was diagnosed according to American Diabetes Association guidelines. Data were collected from medical records. Results: We examined 413 renal allograft recipients, these, 171 (41.4%) received initial immunosuppresion with TAC, 221 (53.5%) CyA and 21 (5.1%) SIR. PTDM occurred in 20.6% of patients in the cohort (85 of 413). The median time to the development of PTDM was 54 days post transplant. The cumulative incidence of PTDM was 24.6% and 17.2% for groups TAC and CyA treatment, respectively. In the analysis by intention to treat, the proportion of patients receiving TAC who developed PTDM was significantly higher than patients receiving CyA (HR=1,563, (CI:95%=1,008–2,425), P=0,006. The Kaplan-Meier method showed that 78,9% patients taking TAC were free of PTDM at six months compared to 87,8% of patients taking CsA (P= 0.044). The other independent risk factors identified were: body mass index (BMI) (P<0,0001), recipient age (P<0,0001) and acute rejections episodes (AR) (P=0,013). There was no statistically significant difference for patients with hepatitis C. Three years actuarial graft survival was 85,5% in patients with PTDM compared with 93,3% for those without diabetes (P=0,021) and patient survival was 88,9% e 96,7%, respectively (P=0,017). Conclusions: The incidence of PTDM is associated with TAC use, the recipient age, BMI and acute rejections episodes. PTDM is an important risk factor for graft loss and mortality. Measures to minimize the risk of this complication should be taken, such as the individualization of immunosuppresive therapy.

Introdução: Diabete Melito Pós-Transplante (DMPT) é considerado uma séria complicação do transplante de rim, podendo diminuir a sobrevida do enxerto e do paciente. O imunossupressor tacrolimo (TAC) pode aumentar o risco de desenvolvimento de DMPT. Objetivos: Estimar o risco de DMPT em pacientes tratados com TAC no Serviço de Transplante Renal da Irmandade da Santa Casa de Misericórdia de Porto Alegre, identificar os demais fatores de risco para o DMPT e suas conseqüências. Métodos: Foram analisados 413 pacientes sem diabetes prévia ao transplante, com 18 anos ou mais, tratados com TAC, ciclosporina (CsA) ou sirolimo (SIR), em uso de corticoterapia e com período de seguimento póstransplante maior de 6 meses. O estudo seguiu o modelo observacional–coorte retrospectivo. Os critérios da Associação Americana de Diabete foram utilizados para o diagnóstico de DMPT. Os dados foram coletados de prontuários. Resultados: Dos 413 pacientes analisados, 171(41,4%) receberam como imunossupressão inicial TAC, 221(53,5%) CsA e 21(5,1%) SIR. DMPT ocorreu em 20,6% dos pacientes da coorte (85 de 413). A mediana do tempo para o desenvolvimento de DMPT foi de 54 dias. A incidência cumulativa de DMPT foi de 24,6% e 17,2% para os grupos de tratamento TAC e CsA, respectivamente. Na análise por intenção de tratamento, o risco para o desenvolvimento de DMPT, ao comparar os grupos TAC vs. CsA foi de HR=1,563, (IC:95%=1,008–2,425), P=0,006. Pelo método de Kaplan-Meier, 78,9% dos pacientes em uso de TAC estavam livres de DMPT no mês 6 vs. 87,8% dos pacientes em uso de CsA (P= 0,044). Os demais fatores de risco independentes identificados foram: índice de massa corporal (IMC) pré-transplante (P<0,0001), idade do receptor (P<0,0001) e episódio de rejeição aguda (RA) (P=0,013). Não houve diferença estatística significativa para anti-HCV reagente do receptor. Em 3 anos, a sobrevida do enxerto, ao comparar os pacientes com diagnóstico de DMPT vs. ausência de DMPT foi de 85,5% e 93,3%, respectivamente (P=0,021) e a sobrevida do paciente foi de 88,9% e 96,7%, respectivamente (P=0,017). Conclusão: A incidência de DMPT está associada com o tipo de imunossupressão utilizada, idade do receptor, IMC pré-transplante e episódio de RA. DMPT é um importante fator de risco para perda do enxerto e mortalidade. Medidas para minimizar o risco dessa complicação devem ser tomadas, como a individualização da terapia imunossupressora. / Introduction: Post-transplant diabetes mellitus (PTDM) is considered a serious complication of kidney transplantation and may reduce the patient and graft survival. The immunosuppressive Tacrolimus (TAC) may increase the risk of developing PTDM. Purpose: To estimate the risk of PTDM in renal transplant recipients treated with TAC in our center, identify all risk factors for PTDM and its consequences. Methodology: We analyzed 413 patients without diabetes prior to transplantation, with age ≥ 18 years, who were treated with tacrolimus (TAC), cyclosporine (CyA) or sirolimus (SIR), under steroids therapy and with a follow-up post-transplant period more than 6 months. We performed a retrospective review – cohort study. PTDM was diagnosed according to American Diabetes Association guidelines. Data were collected from medical records. Results: We examined 413 renal allograft recipients, these, 171 (41.4%) received initial immunosuppresion with TAC, 221 (53.5%) CyA and 21 (5.1%) SIR. PTDM occurred in 20.6% of patients in the cohort (85 of 413). The median time to the development of PTDM was 54 days post transplant. The cumulative incidence of PTDM was 24.6% and 17.2% for groups TAC and CyA treatment, respectively. In the analysis by intention to treat, the proportion of patients receiving TAC who developed PTDM was significantly higher than patients receiving CyA (HR=1,563, (CI:95%=1,008–2,425), P=0,006. The Kaplan-Meier method showed that 78,9% patients taking TAC were free of PTDM at six months compared to 87,8% of patients taking CsA (P= 0.044). The other independent risk factors identified were: body mass index (BMI) (P<0,0001), recipient age (P<0,0001) and acute rejections episodes (AR) (P=0,013). There was no statistically significant difference for patients with hepatitis C. Three years actuarial graft survival was 85,5% in patients with PTDM compared with 93,3% for those without diabetes (P=0,021) and patient survival was 88,9% e 96,7%, respectively (P=0,017). Conclusions: The incidence of PTDM is associated with TAC use, the recipient age, BMI and acute rejections episodes. PTDM is an important risk factor for graft loss and mortality. Measures to minimize the risk of this complication should be taken, such as the individualization of immunosuppresive therapy.