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Mark Molitch Part 7, Post-Kidney Transplant Maintenance

In part 7, the conclusion of this Exclusive Interview, Dr. Mark Molitch talks with with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about the importance of good blood glucose control and continued control in post-transplant patients as referenced in his ADA presentation.

Dr. Mark Molitch is the Martha Leland Sherwin Professor of Medicine at Northwestern in the
Division of Endocrinology, Metabolism and Molecular Medicine. He has been active in clinical research in diabetes, focusing on diabetic nephropathy, and other areas of endocrinology.

Transcript of this video segment:

Steve Freed: The sign of a good presenter is that they take your information that you presented and they use it in their practice. So, what are you trying to get across in your presentation? And I know it was specific.

Mark Molitch:  I think the important thing for the presentation that I did the other day was to try to have people stay in good glycemic control that you need to reduce doses of medications but to avoid hypoglycemia while the same time maintaining reasonable glycemic control. You have to be careful about what drug you can use at what level of decrease in GFR and of course in patients who’ve already had a transplant then try to control their glucose level after transplant to prevent them from further complication

Steve Freed: So once the person has a transplant, how important is blood sugar control?

Mark Molitch: It’s still important. That person still can get eye disease, they get heart disease, they get peripheral neuropathy and foot problems, so they still need to stay under good control.

Steve Freed: So, once a person does get a transplant, the success rate is fairly high, is it not?

Mark Molitch: Oh yeah. For somebody with diabetes, their long-term success of the donor organ – their graft, that liver or that kidney – is very close to the normal population, so, there’s no reason that they shouldn’t continue to do well.

Steve Freed: Obviously, you can only do so many because there’s only so many, but you can actually have a family member donate one and that will go directly to you if it’s a match.

Mark Molitch: Absolutely, the best kind of donor is a living donor and a living related donor is by far is the best. So, if you can get a living kidney, that is far better than a cadaver kidney.

Steve Freed: But there are certain requirements that allow a person to use a family member, but there’s also issues that prevent you from using even if it’s a match. If person has an immediate relative and that relative has type 2 diabetes, would that be a candidate or would they not allow that to happen?

Mark Molitch: In general, they don’t like that to happen, because that person’s kidney may have kidney disease already from their diabetes. Of course, they have to have the right transplantation antigens that match, blood types has to match, there’s a variety of other things, the donor has to be in pretty good shape too.

Steve Freed: Thank you for your time. I thought it was very interesting.

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