title: Transient hyperglycemia during liver transplantation does not affect the early graft function.
abstract: Background and rationale for the study. Hyperglycemia after graft reperfusion is a consistent finding in liver transplantation (LT) that remains poorly studied. We aim to describe its appearance in LT recipients of different types of grafts and its relation to the graft function.
  
  
  METHODS
  436 LT recipients of donors after brain death (DBD), donors after cardiac death (DCD), and familial amyloidotic polyneuropathy (FAP) donors were reviewed. Serum glucose was measured at baseline, during the anhepatic phase, after graft reperfusion, and at the end of surgery. Early graft dysfunction (EAD) was assessed by Olthoff criteria. Caspase-3, IFN-γ, IL1β, and IL6 gene expression were measured in liver biopsy.
  
  
  RESULTS
  The highest increase in glucose levels after reperfusion was observed in FAP LT recipients and the lowest in DCD LT recipients. Glucose level during the anhepatic phase was the only modifiable predictive variable of hyperglycemia after reperfusion. No relation was found between hyperglycemia after reperfusion and EAD. However, recipients with the highest glucose levels after reperfusion tended to achieve the best glucose control at the end of surgery and those who were unable to control the glucose value after reperfusion showed EAD more frequently. The highest levels of caspase-3 were found in recipients with the lowest glucose values after reperfusion. In conclusion, glucose levels increased after graft reperfusion to a different extent according to the donor type. Contrary to general belief, transient hyperglycemia after reperfusion does not appear to impact negatively on the liver graft function and could even be suggested as a marker of graft quality.
authors.affiliation: Anesthesia Department. Hospital Clinic. Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona. Spain.
authors.forename: Annabel
authors.initials: A
authors.lastname: Blasi
authors.affiliation: Anesthesia Department. Hospital Clinic. Barcelona. Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Beltran
authors.affiliation: Anesthesia Department. Hospital Clinic. Barcelona. Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Martin
authors.affiliation: Anesthesia Department. Hospital Clinic. Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona. Spain.
authors.forename: Graciela
authors.initials: G
authors.lastname: Martinez-Pallí
authors.affiliation: Bioinformatics Platform, CIBERehd, Barcelona. Spain.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Lozano
authors.affiliation: Anesthesia Department. Hospital Clinic. Barcelona. Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Balust
authors.affiliation: Bioinformatics Platform, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona. Spain.
authors.forename: Abigail
authors.initials: A
authors.lastname: Torrents
authors.affiliation: Anesthesia Department. Hospital Clinic. Barcelona. Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Taura
mesh_terms: D000328:Adult; D000368:Aged; D028227:Amyloid Neuropathies, Familial; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D001786:Blood Glucose / Q000378:metabolism*; D001926:Brain Death; D002423:Cause of Death; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D055031:Primary Graft Dysfunction / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose