title: Glucose Metabolism and Associated Outcome After Pediatric Liver Transplantation.
abstract: BACKGROUND
  Despite hypoglycemia and hyperglycemia being frequently observed in the early postoperative phase, information on glucose metabolism after pediatric liver transplantation (pLT) is scarce.
  
  
  METHODS
  The goal of this retrospective single-center study, which included 46 patients who consecutively underwent 55 liver transplantations, was to gather data on glucose uptake, the prognostic relevance of hyperglycemia, and the safety of insulin administration in patients after pLT.
  
  
  RESULTS
  In this study population, glucose intake to keep blood sugar levels (BSLs) within the targeted range of 120 to 200 mg/dL (6.7-11.1 mmol/L) increased rapidly over the first few postoperative days and was significantly correlated with graft function. There was no association between a postoperative daily mean BSL >200 mg/dL and specific posttransplant complications (acute rejection, infection, need for retransplantation, and/or death). High postoperative mean 7-day BSLs were associated with poor glucose metabolism and an increase in morbidity and 6-month posttransplant mortality. Hypoglycemia was not observed under insulin administration.
  
  
  CONCLUSIONS
  With high BSLs being associated with poor glucose metabolism, it is likely that the critical illness itself, in addition to poor graft function, causes the increase in morbidity and mortality, with hyperglycemia serving as a marker.
authors: KUNO University Children's Hospital Regensburg, Regensburg, Germany. Electronic address: robert.zant@ukr.de.
authors: R
authors: R
authors: Zant
authors: KUNO University Children's Hospital Regensburg, Regensburg, Germany.
authors: M
authors: M
authors: Melter
authors: KUNO University Children's Hospital Regensburg, Regensburg, Germany.
authors: D
authors: D
authors: Beck
authors: KUNO University Children's Hospital Regensburg, Regensburg, Germany.
authors: M
authors: M
authors: Ameres
authors: KUNO University Children's Hospital Regensburg, Regensburg, Germany.
authors: B
authors: B
authors: Knoppke
authors: KUNO University Children's Hospital Regensburg, Regensburg, Germany.
authors: J
authors: J
authors: Kunkel
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D016638:Critical Illness; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000188:drug therapy; D007223:Infant; D007328:Insulin / Q000008:administration & dosage; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D007328:Insulin