Perioperative Predictors for Refractory Hyperglycemia During the Neohepatic Phase of Liver Transplantation

Chung, Hyun Sik; Lee, S.; Kwon, Soon-Yong; Park, C.S.

doi:10.1016/j.transproceed.2014.06.078

Cited by 3 publications

(3 citation statements)

References 37 publications

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“…Patients with PTDM who had adequate glycemic control (defined as HbA1c < 7%), were significantly less dependent on insulin (39.4%) compared to patients with inadequate glycemic control (80.8%) (OR 6.6, 95%CI: 1.8-24.6, P < 0.001). Finally, Chung et al[ 25 ] found male sex, emergency surgery, surgical time (≤ 9 h), and serum lactate (> 5 mmol/L) to be independent predictors for refractive hyperglycemia (RH), however, most post-LT outcomes were not significant in relation to RH.…”

Section: Resultsmentioning

confidence: 99%

Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review

Paka

Lieber

Lee

et al. 2018

WJT

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AIMTo investigate the relationship between post-liver transplantation (LT) glycemic control and LT outcomes.METHODSA qualitative systematic review on relevant prospective interventions designed to control glucose levels including insulin protocols. Studies investigating an association between glycemic control and post-LT outcomes such as mortality, graft rejection, and infection rate were reviewed. PubMed, EMBASE, and other databases were searched through October 2016.RESULTSThree thousands, six hundreds and ninety-two patients from 14 studies were included. Higher mortality rate was seen when blood glucose (BG) ≥ 150 mg/dL (P = 0.05). BG ≥ 150 mg/dL also led to higher rates of infection. Higher rates of graft rejection were seen at BG > 200 mg/dL (P < 0.001). Mean BG ≥ 200 mg/dL was associated with more infections (P = 0.002). Nurse-initiated protocols and early screening strategies have shown a reduction in negative post-LT outcomes.CONCLUSIONHyperglycemia in the perioperative period is associated with poor post-LT outcomes. Only a few prospective studies have designed interventions aimed at managing post-LT hyperglycemia, post-transplant diabetes mellitus (PTDM) and their impact on post-LT outcomes.

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Section: Resultsmentioning

confidence: 99%

Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review

Paka

Lieber

Lee

et al. 2018

WJT

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“… 3 , 20 Furthermore, hyperglycemia in the post-LT (reperfusion) phase has been correlated with delay in the functional recovery of the LT graft. 21 It is also important to mention that, DM is an independent risk factor for postreperfusion severe hyperglycemia. 21 …”

Section: Discussionmentioning

confidence: 99%

“… 21 It is also important to mention that, DM is an independent risk factor for postreperfusion severe hyperglycemia. 21 …”

Section: Discussionmentioning

confidence: 99%

Development of a Predictive Model for Hyperglycemia in Nondiabetic Recipients After Liver Transplantation

Zelada

VanWagner

Pollack

et al. 2018

Transplantation Direct

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BackgroundPosttransplant hyperglycemia has been associated with increased risks of transplant rejection, infections, length of stay, and mortality.MethodsTo establish a predictive model to identify nondiabetic recipients at risk for developing postliver transplant (LT) hyperglycemia, we performed this secondary, retrospective data analysis of a single-center, prospective, randomized, controlled trial of glycemic control among 107 adult LT recipients in the inpatient period. Hyperglycemia was defined as a posttransplant glucose level greater than 200 mg/dL after initial discharge up to 1 month following surgery. Candidate variables with P less than 0.10 in univariate analyses were used to build a multivariable logistic regression model using forward stepwise selection. The final model chosen was based on statistical significance and additive contribution to the model based on the Bayesian Information Criteria.ResultsForty-three (40.2%) patients had at least 1 episode of hyperglycemia after transplant after the resolution of the initial postoperative hyperglycemia. Variables selected for inclusion in the model (using model optimization strategies) included length of hospital stay (odds ratio [OR], 0.83; P < 0.001), use of glucose-lowering medications at discharge (OR, 3.76; P = 0.03), donor female sex (OR, 3.18; P = 0.02) and donor white race (OR, 3.62; P = 0.01). The model had good calibration (Hosmer-Lemeshow goodness-of-fit test statistic = 9.74, P = 0.28) and discrimination (C-statistic = 0.78; 95% confidence interval, 0.65-0.81, bias-corrected C-statistic = 0.78).ConclusionsShorter hospital stay, use of glucose-lowering medications at discharge, donor female sex and donor white race are important determinants in predicting hyperglycemia in nondiabetic recipients after hospital discharge up to 1 month after liver transplantation.

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Correlation of Deceased Donor Factors to Postreperfusion Severe Hyperglycemia in Adult Patients Undergoing Liver Transplant

Milani¹,

Jafari²,

Aghaee³

et al. 2021

Exp Clin Transplant

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Perioperative Predictors for Refractory Hyperglycemia During the Neohepatic Phase of Liver Transplantation

Cited by 3 publications

References 37 publications

Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review

Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review

Development of a Predictive Model for Hyperglycemia in Nondiabetic Recipients After Liver Transplantation

Correlation of Deceased Donor Factors to Postreperfusion Severe Hyperglycemia in Adult Patients Undergoing Liver Transplant

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