Transient hyperglycemia during liver transplantation does not affect the early graft function

Area of Science:

• Hepatology
• Transplantation immunology
• Metabolic disorders

Background:

• Hyperglycemia post-liver reperfusion is common in liver transplantation (LT) but poorly understood.
• The impact of post-reperfusion hyperglycemia on liver graft function requires further investigation.

Purpose of the Study:

• To characterize post-reperfusion hyperglycemia in LT recipients across different donor types.
• To explore the relationship between post-reperfusion hyperglycemia and early graft dysfunction (EAD).

Main Methods:

• Retrospective review of 436 LT recipients from donors after brain death (DBD), donors after cardiac death (DCD), and familial amyloidotic polyneuropathy (FAP) donors.
• Serum glucose monitoring at multiple surgical time points.
• Assessment of early graft dysfunction (EAD) using Olthoff criteria and measurement of inflammatory markers (caspase-3, IFN-γ, IL1β, IL6).

Main Results:

• Familial amyloidotic polyneuropathy (FAP) donors showed the greatest post-reperfusion glucose increase, while donors after cardiac death (DCD) showed the least.
• Pre-reperfusion glucose levels were the only modifiable predictor of post-reperfusion hyperglycemia.
• No direct correlation was found between post-reperfusion hyperglycemia and EAD; however, uncontrolled hyperglycemia was associated with higher EAD rates.

Conclusions:

• Post-reperfusion hyperglycemia in liver transplantation varies significantly based on donor type.
• Transient hyperglycemia post-reperfusion does not negatively impact liver graft function and may serve as a marker of graft quality.