Assessment of HCV - Induced Insulin Resistance in Egyptian HCV End - Stage Cirrhotic Patients before and after Living Donor Liver Transplantation ( LDLT )

2013 ◽  
Vol 64 (4-6) ◽  
pp. 401-411
Author(s):  
Mohammad Sakr ◽  
Mahmoud Elmeteini ◽  
Magdah Elmonayeri ◽  
Eman Barakat ◽  
Sara Abdelhakam ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Before And After ◽  
Cirrhotic Patients ◽  
End Stage

Adult-to-Adult Living Donor Liver Transplantation: History, Current Practice, and Implications for the Future

2005 ◽  
Vol 15 (1) ◽  
pp. 36-44
Author(s):  
Claire Curran
Keyword(s):  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
The United States ◽  
Hepatitis C Infection ◽  
Donor Liver ◽  
Excessive Pressure ◽  
Donor Liver Transplantation ◽  
Number Of Patients ◽  
End Stage

More than 1600 Americans have received adult-to-adult living donor liver transplants. As the number of patients with end-stage liver disease is expected to grow significantly in the next 20 years due to hepatitis C infection, living donor liver transplantation has become a promising solution to the shortage of donor organs. The use of living donors provides organs in an environment of scarcity, allows patients to receive transplants when medically optimized, and produces liver segments with minimal ischemic damage. The donor complications most frequently cited in the medical literature include bile leaks and strictures, biloma, hepatic encephalopathy, wound infection, and pressure sores. In the wake of 2 donor deaths in the United States and subsequent media publicity, there have been new efforts by the transplant community to describe the risks and outcomes for donors, and establish safeguards to protect them from excessive pressure to donate.

scholarly journals Stress burden related to postreperfusion syndrome may aggravate hyperglycemia with insulin resistance during living donor liver transplantation: A propensity score-matching analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243873
Author(s):  
Sumin Chae ◽  
Junghee Choi ◽  
Sujin Lim ◽  
Ho Joong Choi ◽  
Jaesik Park ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Liver Transplantation ◽  
Propensity Score ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Plasma Concentrations ◽  
Donor Liver ◽  
C Peptide ◽  
Donor Liver Transplantation ◽  
The Impact

Background 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.

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