Predictive roles of intraoperative blood glucose for posttransplant outcomes in liver transplantation

Chul Soo Park

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Diabetogenic traits in patients undergoing liver transplantation (LT) are exacerbated intraoperatively by exogenous causes, such as surgical stress, steroids, blood transfusions, and catecholamines, which lead to intraoperative hyperglycemia. In contrast to the strict glucose control performed in the intensive care unit, no systematic protocol has been developed for glucose management during LT. Intraoperative blood glucose concentrations typically exceed 200 mg/dL in LT, and extreme hyperglycemia (> 300 mg/dL) is common during the neohepatic phase. Only a few retrospective studies have examined the relationship between intraoperative hyperglycemia and posttransplant complications, with reports of infectious complications or mortality. However, no prospective studies have been conducted regarding the influence of intraoperative hyperglycemia in LT on post-transplant outcome. In addition to absolute blood glucose values, the temporal patterns in blood glucose levels during LT may serve as prognostic features. Persistent neohepatic hyperglycemia (without a decline) throughout LT is a useful indicator of early graft dysfunction. Moreover, intraoperative variability in glucose levels may predict the need for reoperation for hemorrhage after LT. Thus, there is an urgent need for guidelines for glucose control in these patients, as well as prospective studies on the impact of glucose control on various posttransplant complications. This report highlights some of the recent studies related to perioperative blood glucose management focused on LT and liver disease.

Original languageEnglish
Pages (from-to)6835-6841
Number of pages7
JournalWorld Journal of Gastroenterology
Volume21
Issue number22
DOIs
StatePublished - 14 Jun 2015

Bibliographical note

Publisher Copyright:
© 2015 Baishideng Publishing Group Inc. All rights reserved.

Keywords

  • Blood glucose
  • Intraoperative
  • Liver transplantation
  • Outcome
  • Prediction

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