In:
PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 12 ( 2020-12-10), p. e0243873-
Abstract:
We investigated the impact of postreperfusion syndrome (PRS) on hyperglycemia occurrence and connecting (C) peptide release, which acts as a surrogate marker for insulin resistance, during the intraoperative period after graft reperfusion in patients undergoing living donor liver transplantation (LDLT) using propensity score (PS)-matching analysis. Patients and methods Medical records from 324 adult patients who underwent elective LDLT were retrospectively reviewed, and their data were analyzed according to PRS occurrence (PRS vs. non-PRS groups) using the PS-matching method. Intraoperative levels of blood glucose and C-peptide were measured through the arterial or venous line at each surgical phase. Hyperglycemia was defined as a peak glucose level 〉 200 mg/dL, and normal plasma concentrations of C-peptide in the fasting state were taken to range between 0.5 and 2.0 ng/mL. Results After PS matching, there were no significant differences in pre- and intra-operative recipient findings and donor-graft findings between groups. Although glucose and C-peptide levels continuously increased through the surgical phases in both groups, glucose and C-peptide levels during the neohepatic phase were significantly higher in the PRS group than in the non-PRS group, and larger changes in levels were observed between the preanhepatic and neohepatic phases. There were higher incidences of C-peptide levels 〉 2.0 ng/mL and peak glucose levels 〉 200 mg/dL in the neohepatic phase in patients with PRS than in those without. PRS adjusted for PS with or without exogenous insulin infusion was significantly associated with hyperglycemia occurrence during the neohepatic phase. Conclusions Elucidating the association between PRS and hyperglycemia occurrence will help with establishing a standard protocol for intraoperative glycemic control in patients undergoing LDLT.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0243873
DOI:
10.1371/journal.pone.0243873.g001
DOI:
10.1371/journal.pone.0243873.g002
DOI:
10.1371/journal.pone.0243873.g003
DOI:
10.1371/journal.pone.0243873.t001
DOI:
10.1371/journal.pone.0243873.t002
DOI:
10.1371/journal.pone.0243873.t003
DOI:
10.1371/journal.pone.0243873.s001
DOI:
10.1371/journal.pone.0243873.s002
DOI:
10.1371/journal.pone.0243873.s003
DOI:
10.1371/journal.pone.0243873.s004
DOI:
10.1371/journal.pone.0243873.s005
DOI:
10.1371/journal.pone.0243873.r001
DOI:
10.1371/journal.pone.0243873.r002
DOI:
10.1371/journal.pone.0243873.r003
DOI:
10.1371/journal.pone.0243873.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2020
detail.hit.zdb_id:
2267670-3
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