Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

03 June 2015 : Original article  

Contribution of Donor Factors to Post-Reperfusion Severe Hyperglycemia in Patients Undergoing Living Donor Liver Transplantation

Hyun Sik ChungBDE, Eun Sung KimCF, Min Cheol RhoB, Chul Soo ParkACDEF

DOI: 10.12659/AOT.893648

Ann Transplant 2015; 20:303-311

Abstract

BACKGROUND: Blood glucose levels increase abruptly after graft reperfusion during living donor liver transplantation (LDLT), but studies on perioperative factors contributing to this phenomenon are rare. We developed a predictive model for post-reperfusion severe hyperglycemia (PRSH) based on donor-related factors.

MATERIAL AND METHODS: Preoperative and intraoperative recipient data, as well as donor data, on 279 LDLT cases were reviewed. The mean blood glucose levels at each LDLT surgical phase were calculated, and patients were divided into PRSH and non-PRSH groups using a cutoff of 230 mg/dL mean blood glucose level during the neo-hepatic phase. Perioperative variables were compared between the 2 groups, and selected variables were subjected to multivariate logistic regression to establish a predictive model for PRSH.

RESULTS: There were 128 patients (45.9%) who developed PRSH, which was associated with preoperative diabetes mellitus but not with model for end-stage liver disease or Child-Pugh-Turcotte score. Intraoperatively, the PRSH group required more blood transfusions and experienced more circulatory insufficiency than did the non-PRSH group. PRSH patients received grafts with higher-level fatty changes and greater graft-to-recipient ratios (GRWRs) (both p<0.05). The multivariate predictive model included GRWR, graft fatty change ≥10% (OR 3.53), post-reperfusion syndrome ≥5 min in duration (OR 5.68), and recipient diabetes mellitus (OR 2.92) as independent risk factors. The risk of PRSH was proportional to the rise in GRWR.

CONCLUSIONS: PRSH development was heavily influenced by donor-related factors. Graft size, extent of fatty change, and post-reperfusion syndrome were identified as independent donor-associated predictors of PRSH.

Keywords: Hyperglycemia, Intraoperative Complications, Liver Transplantation, Living Donors, Reperfusion

Add Comment 0 Comments

Most Viewed Current Articles

15 Aug 2023 : Review article   7,203

Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ Transplantation

DOI :10.12659/AOT.939750

Ann Transplant 2023; 28:e939750

03 Jan 2023 : Original article   7,086

Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...

DOI :10.12659/AOT.938467

Ann Transplant 2023; 28:e938467

16 May 2023 : Original article   6,914

Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...

DOI :10.12659/AOT.939258

Ann Transplant 2023; 28:e939258

28 May 2024 : Original article   6,394

Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...

DOI :10.12659/AOT.943281

Ann Transplant 2024; 29:e943281

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358