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Ann Hepatol ; 14(5): 675-87, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26256896

RESUMEN

UNLABELLED: Background and rationale for the study. Hyperglycemia after graft reperfusion is a consistent finding in liver transplantation (LT) that remains poorly studied. We aim to describe its appearance in LT recipients of different types of grafts and its relation to the graft function. MATERIAL & METHODS: 436 LT recipients of donors after brain death (DBD), donors after cardiac death (DCD), and familial amyloidotic polyneuropathy (FAP) donors were reviewed. Serum glucose was measured at baseline, during the anhepatic phase, after graft reperfusion, and at the end of surgery. Early graft dysfunction (EAD) was assessed by Olthoff criteria. Caspase-3, IFN-γ, IL1ß, and IL6 gene expression were measured in liver biopsy. RESULTS: The highest increase in glucose levels after reperfusion was observed in FAP LT recipients and the lowest in DCD LT recipients. Glucose level during the anhepatic phase was the only modifiable predictive variable of hyperglycemia after reperfusion. No relation was found between hyperglycemia after reperfusion and EAD. However, recipients with the highest glucose levels after reperfusion tended to achieve the best glucose control at the end of surgery and those who were unable to control the glucose value after reperfusion showed EAD more frequently. The highest levels of caspase-3 were found in recipients with the lowest glucose values after reperfusion. In conclusion, glucose levels increased after graft reperfusion to a different extent according to the donor type. Contrary to general belief, transient hyperglycemia after reperfusion does not appear to impact negatively on the liver graft function and could even be suggested as a marker of graft quality.


Asunto(s)
Glucemia/metabolismo , Hiperglucemia/etiología , Trasplante de Hígado/efectos adversos , Donantes de Tejidos , Adulto , Anciano , Neuropatías Amiloides Familiares , Biomarcadores/sangre , Biopsia , Muerte Encefálica , Causas de Muerte , Femenino , Humanos , Hiperglucemia/sangre , Hiperglucemia/diagnóstico , Pruebas de Función Hepática , Trasplante de Hígado/métodos , Masculino , Persona de Mediana Edad , Disfunción Primaria del Injerto/etiología , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
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