Glucose balance of porcine liver allograft is an important predictor of outcome.
BACKGROUND
The role of glucose metabolism in predicting postoperative liver graft function after transplantation is unclear. We investigated the relation between intraoperative glucose balance of the liver allograft and the postoperative graft function and survival in a porcine partial liver transplant model.


METHODS
Experiments follow Guiding Principles in the Care and Use of Animals. Fourteen female pigs received liver allografts of 17%-39% recipient liver volume. Recipients were classified into two groups based on positive glucose balance: the mean intraoperative blood glucose of the graft outflow was greater than the blood glucose of inflow, negative glucose balance: the mean blood glucose of graft outflow was less than blood glucose of inflow. Perioperative data and survival were studied.


RESULTS
In the positive group (n=9) intraoperative hepatic artery flow was significantly higher (P=0.028), and oxygen consumption was lower (P=0.018) than the negative group (n=5). Postoperatively, maximal serum aspartate aminotransferase (AST) (P=0.028), alanine aminotransferase (ALT) (P=0.028), and total bilirubin (P=0.027) of the positive group were significantly lower than the negative group. In survival analysis, the positive group had significantly better survival rate than the negative group (P=0.034). Using Periodic acid-Schiff staining, glycogen content of the allograft in the positive group at 10 min post-reperfusion was significantly decreased in comparison with the baseline value in the normal liver (P=0.005), however not statistically different in the negative group (P=0.175).


CONCLUSIONS
Intraoperative glucose balance can be used as an early predictor of the graft function following transplantation of partial liver allografts.
Shiba
Hiroaki
H
Department of HPB and Transplant Surgery, Cleveland Clinic, Cleveland, Ohio 44195, USA.
Zhu
Xiaocheng
X
Arakawa
Yusuke
Y
Irefin
Samuel
S
Wang
Bin
B
Trenti
Loris
L
Sanchez
Ivan P
IP
Fung
John J
JJ
Kelly
Dympna M
DM
D000818:Animals; D021461:Animals, Outbred Strains; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000494:pharmacology; D006003:Glycogen / Q000378:metabolism; D006085:Graft Survival / Q000187:drug effects / Q000502:physiology*; D008099:Liver / Q000378:metabolism; D016031:Liver Transplantation / Q000401:mortality*; D011183:Postoperative Complications / Q000378:metabolism* / Q000401:mortality*; D011237:Predictive Value of Tests; D016019:Survival Analysis; D013552:Swine; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D006003:Glycogen; D005947:Glucose