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| New-onset hyperglycemia immediately after liver transplantation: A national survey from China Liver Transplant Registry |
| Qing-Hong Ke a , b , Hai-Tao Huang a , Qi Ling a , b , Ji-Min Liu a , c , Si-Yi Dong d , Xiang-Xiang He d , Wen-Jin Zhang a , b , Shu-Sen Zheng a , b , ∗ |
a Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
b Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Hangzhou 310003, China
c Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
d China Liver Transplant Registry, Hangzhou 310003, China
∗ Corresponding author at: Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
E-mail address: zyzss@zju.edu.cn (S.-S. Zheng). |
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Abstract BACKGROUND:
New-onset hyperglycemia (NOH) is a common phenomenon after liver transplantation (LT), but its impact on clinical outcomes has not yet been fully assessed. We aimed to evaluate the etiology and prognosis of NOH within 1 month after LT.
METHODS:
The data of 3339 adult patients who underwent primary LT from donation after citizen death between January 2010 and June 2016 were extracted from China Liver Transplant Registry database and analyzed. NOH was defined as fasting blood glucose ≥7.0?mmol/L confirmed on at least two occasions within the first post-transplant month with or without hypoglycemic agent.
RESULTS:
Of 3339 liver recipients, 1416 (42.4%) developed NOH. Recipients with NOH had higher incidence of post-transplant complications such as graft and kidney failure, infection, biliary stricture, cholangitis, and tumor recurrence in a glucose concentration-dependent manner as compared to non-NOH recipients (P < 0.05). The independent risk factors of NOH were donor warm ischemic time >10?min, cold ischemic time >10?h, anhepatic time >60?min, recipient model for end-stage liver disease score >30, moderate ascites and corticosteroid usage (P?<?0.05). Liver enzymes (alanine aminotransferase and gamma-glutamyltranspeptidase) on post-transplant day 7 significantly correlated with NOH (P?<?0.001).
CONCLUSIONS:
NOH leads to increased morbidity and mortality in liver recipients. Close surveillance and tight control of blood glucose are desiderated immediately following LT particularly in those with delayed graft function and receiving corticosteroid. Strategic targeting graft ischemic injury may help maintain glucose homeostasis.
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2018, Vol. 17 
