Deceased Donor Hyperglycemia and Liver Graft Dysfunction
| Autor: | Daniel I. Sessler, Silvia Perez-Protto, Cristiano Quintini, Jarrod E. Dalton, Brian M. Parker, Samuel Irefin, Taro Taketomi, Luke F. Reynolds |
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| Rok vydání: | 2014 |
| Předmět: |
Graft Rejection
Male medicine.medical_specialty Graft dysfunction medicine.medical_treatment Liver transplantation Liver transplants Gastroenterology Risk Factors Internal medicine medicine Humans Adverse effect Prothrombin time Transplantation Deceased donor medicine.diagnostic_test business.industry Liver Diseases Incidence (epidemiology) Middle Aged Tissue Donors Liver Transplantation Surgery Liver graft Hyperglycemia Female business |
| Zdroj: | Progress in Transplantation. 24:106-112 |
| ISSN: | 2164-6708 1526-9248 |
| Popis: | Context Hyperglycemia is common in deceased donors, and provokes numerous adverse events in hepatocytic mitochondria. Objective To determine whether hyperglycemia in deceased donors is associated with graft dysfunction after orthotopic liver transplant. Methods Charts on 572 liver transplants performed at the Cleveland Clinic between January 2005 and October 2010 were reviewed. The primary measure was time-weighted averages of donors' glucose measurements. Liver graft dysfunction was defined as (1) primary nonfunction as indicated by death or retransplant or (2) liver graft dysfunction as indicated by an aspartate amino transferase level greater than 2000 U/L or prothrombin time greater than 16 seconds during the first postoperative week. The relationship of interest was estimated by using a multivariable logistic regression. Results The incidence of graft dysfunction was 25%. No significant relationship was found between the range of donor glucose measurements and liver graft dysfunction after donor characteristics were adjusted for ( P = .14, Wald test, adjusted odds ratio [95% CI] for liver graft dysfunction corresponding to a relative doubling in time-weighted average for donor glucose of 1.43 [0.89–2.30]). The results thus do not suggest that strict glucose control in donors is likely to improve graft quality. |
| Databáze: | OpenAIRE |
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