Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Jul 18, 2021; 11(7): 254-262
Published online Jul 18, 2021. doi: 10.5500/wjt.v11.i7.254
Chances and risks of sodium-glucose cotransporter 2 inhibitors in solid organ transplantation: A review of literatures
Marlene Schwarzenbach, Flavia Elena Bernhard, Cecilia Czerlau, Daniel Sidler
Marlene Schwarzenbach, Flavia Elena Bernhard, Cecilia Czerlau, Daniel Sidler, Department of Nephrology and Hypertension, University Hospital Insel Bern, Bern 3010, Switzerland
Author contributions: Czerlau C and Sidler D designed the study; Schwarzenbach M and Bernhard FE performed the literature search; Schwarzenbach M, Bernhard FE, Czerlau C and Sidler D wrote the paper.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Daniel Sidler, MD, PhD, Assistant Professor, Consultant Physician-Scientist, Senior Researcher, Department of Nephrology and Hypertension, University Hospital Insel Bern, Freiburgstrasse, Bern 3010, Switzerland.
Received: January 11, 2021
Peer-review started: January 11, 2021
First decision: May 5, 2021
Revised: May 17, 2021
Accepted: May 26, 2021
Article in press: May 26, 2021
Published online: July 18, 2021

Solid organ transplantation offers life-saving treatment for patients with end-organ dysfunction. Patient survival and quality of life have improved over the past few decades as a result of pharmacological development, expansion of the donor pool, technological advances and standardization of practices related to transplantation. Still, transplantation is associated with cardiovascular complications, of which post-transplant diabetes mellitus (PTDM) is one of the most important. PTDM increases mortality, which is best documented in patients who have received kidney and heart transplants. PTDM results from traditional risk factors seen in patients with type 2 diabetes mellitus, but also from specific post-transplant risk factors such as metabolic side effects of immunosuppressive drugs, post-transplant viral infections and hypomagnesemia. Oral hypoglycaemic agents are the first choice for the treatment of type 2 diabetes mellitus in non-transplanted patients. However, the evidence on the safety and efficacy of oral hypoglycaemic agents in transplant recipients is limited. The favourable risk/benefit ratio, which is suggested by large-scale and long-term studies on new glucose-lowering drug classes such as glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors, makes studies warranted to assess the potential role of these agents in the management of PTDM.

Keywords: Solid organ transplantation, Post-transplant diabetes mellitus, Antidiabetic treatment, Sodium-glucose cotransporter 2 inhibitors, Renoprotection

Core Tip: Literature review of efficacy and side effects of sodium-glucose cotransporter 2 inhibitors in diabetes management specifically in solid organ recipients.