Plasma Glucose Concentrations During Liver Transplantation

Atchison, Scott R.; Rettke, Steven R.; Fromme, Glenn A.; Jánossy, T; Kunkel, S. L.; Williamson, Kenneth R.; Perkins, James D.; Rakela, Jorge

doi:10.1016/s0025-6196(12)65679-1

Cited by 29 publications

(19 citation statements)

References 13 publications

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“…Thus, insulin and C-peptide were expected to increase during the AH, as reported previously [5]. In contrast, both insulin and C-peptide decreased slightly in our case.…”

Section: Discussionsupporting

confidence: 85%

Glucose Homeostasis in a Diabetic Patient during Liver Transplantation: A Case Report

et al. 2007

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Abstract.A 66-year-old woman with type C hepatitis had been treated for hepatocellular carcinoma (HCC) with transcatheter arterial embolization and radiofrequency ablation. Liver function worsened gradually to decompensated liver cirrhosis. She had recurrence of HCC and was later admitted to Juntendo University Hospital for living-donor liver transplantation. Although blood glucose was high, she had never been diagnosed with diabetes mellitus. No diabetesrelated complications were detected at that time. We started treatment with multiple insulin injections. There is a unique time called the anhepatic phase during liver transplantation during which the liver does not exist in the body. Recent reports show that it is not necessary to administer glucose for patients with normal glucose tolerance during the anhepatic phase since plasma glucose could be maintained at normoglycemia to hyperglycemia (100-150 mg/dl). In our patient, plasma glucose concentration was rather high during the anhepatic phase without glucose administration. We analyzed the levels of blood glucose, insulin and various other hormones during the anhepatic phase. This could be the first report on glucose homeostasis during the anhepatic phase in a diabetic patient.

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“…Thus, insulin and C-peptide were expected to increase during the AH, as reported previously [5]. In contrast, both insulin and C-peptide decreased slightly in our case.…”

Section: Discussionsupporting

confidence: 85%

Glucose Homeostasis in a Diabetic Patient during Liver Transplantation: A Case Report

et al. 2007

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“…Contrary to earlier reports [1] , hyperglycemia during liver transplantation (LT) is a common finding [2][3][4] . Normal blood glucose levels could even be maintained during LT procedure in humans [2] and dogs [5] with blood as the only source of dextrose.…”

Section: Introductionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

“…Normal blood glucose levels could even be maintained during LT procedure in humans [2] and dogs [5] with blood as the only source of dextrose. The mechanism is attributed to blood transfusion, which contains dextrose as part of the storage solution [2,3] . Blood transfusion in LT was once a common feature in the past, however, with increasing LT experience, the blood loss and subsequent blood and blood product replacement during operations have decreased gradually [6,7] .…”

Section: Introductionmentioning

confidence: 99%

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Dextrose in the banked blood products does not seem to affect the blood glucose levels in patients undergoing liver transplantation

Cheng

Chen

Cheng

et al. 2005

WJG

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AIM: Hyperglycemia commonly seen in liver transplantation (LT) has often been attributed to the dextrose in the storage solution of blood transfusion products. The purpose of the study is to compare the changes of the blood glucose levels in transfused and non-transfused patients during LT. METHODS:A retrospective study on 60 biliary pediatric patients and 16 adult patients undergoing LT was carried out. Transfused pediatric patients were included in Group I (GI), those not transfused in Group II (GII). Twelve adult patients were not given transfusion and assigned to Group III (GIII); whereas, four adult patients who received massive transfusion were assigned to Group IV (GIV). The blood glucose levels, volume of blood transfused, and the volume of crystalloid infused were recorded, compared and analyzed. RESULTS:Results showed that the changes in blood glucose levels during LT for both non-transfused and minimally transfused pediatric groups and non-transfused and massively-transfused adult groups were almost the same. CONCLUSION:We conclude that blood transfusion does not cause significant changes in the blood glucose levels in this study.

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“…Blood glucose (BG) evolution is highly variable and difficult to control for liver transplant (LT) patients during and after surgery, particularly after reperfusion in the post-anhepatic phase [2] [3] [4]. Fig.1 shows this behaviour and how the BG level increases significantly and variably during reperfusion.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Model Based and Clinical Blood Glucose Evolution during and after Anhepatic Status

Homlok¹,

Chase²,

Turi³

et al. 2013

Biomedical Engineering / Biomedizinische Technik

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Blood glucose (BG) control is a major difficulty during liver transplantation (LT). A model-based approach to analysis and control can enhance the efficiency of BG management during LT surgery. An existing clinically validated metabolic model was fitted to data from 8 LT patients. The reperfusion part of the post-anhepatic phase of LT shows a clear consistent dynamic rise in blood glucose (BG) level that would enable better prediction of future BG in this phase. Model fitting errors showed that the fundamental model captured all primary dynamics but parameter adjustment to reflect known conditions during LT surgery in specific phases would improve model quality.

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Plasma Glucose Concentrations During Liver Transplantation

Cited by 29 publications

References 13 publications

Glucose Homeostasis in a Diabetic Patient during Liver Transplantation: A Case Report

Glucose Homeostasis in a Diabetic Patient during Liver Transplantation: A Case Report

Dextrose in the banked blood products does not seem to affect the blood glucose levels in patients undergoing liver transplantation

Comparison of Model Based and Clinical Blood Glucose Evolution during and after Anhepatic Status

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