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Published on: May 5, 2018

Glucose homeostasis in a diabetic patient during liver transplantation: a case report

Masayuki Arakawa1, Takahisa Hirose, Tomoya Mita

  • 1Department of Medicine, Metabolism and Endocrinology, Juntendo University, School of Medicine, Tokyo, Japan.

Endocrine Journal
|September 6, 2007
PubMed

Insights

This study explores glucose regulation during the anhepatic phase of liver transplantation in a patient with undiagnosed diabetes. It highlights high blood glucose levels and hormonal changes, offering insights into glucose homeostasis in diabetic patients during this critical period.

Area of Science:

  • Hepatology
  • Endocrinology
  • Transplantation Medicine

Background:

  • A 66-year-old woman with recurrent hepatocellular carcinoma (HCC) and decompensated liver cirrhosis underwent living-donor liver transplantation.
  • The patient presented with hyperglycemia but no prior diabetes diagnosis or complications.

Observation:

  • During the anhepatic phase, a critical period without a liver, the patient exhibited elevated plasma glucose levels without exogenous glucose administration.
  • Hormonal levels, including insulin, blood glucose, and other relevant hormones, were monitored throughout the anhepatic phase.

Findings:

  • Contrary to expectations for non-diabetic patients, this patient's glucose levels remained high during the anhepatic phase without glucose infusion.
  • This case provides initial data on glucose homeostasis during the anhepatic phase in a patient with previously undiagnosed diabetes mellitus.

Implications:

  • Understanding glucose metabolism during the anhepatic phase is crucial for managing diabetic patients undergoing liver transplantation.
  • This case underscores the need for careful glucose monitoring and tailored insulin management in diabetic liver transplant recipients.
  • Further research is warranted to elucidate the specific hormonal and metabolic mechanisms governing glucose homeostasis in diabetic patients during the anhepatic phase.

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