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Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review

AIM: To investigate the relationship between post-liver transplantation (LT) glycemic control and LT outcomes. METHODS: A qualitative systematic review on relevant prospective interventions designed to control glucose levels including insulin protocols. Studies investigating an association between g...

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Autores principales: Paka, Prani, Lieber, Sarah R, Lee, Ruth-Ann, Desai, Chirag S, Dupuis, Robert E, Barritt, Alfred Sidney
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033739/
https://www.ncbi.nlm.nih.gov/pubmed/29988867
http://dx.doi.org/10.5500/wjt.v8.i3.75
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author Paka, Prani
Lieber, Sarah R
Lee, Ruth-Ann
Desai, Chirag S
Dupuis, Robert E
Barritt, Alfred Sidney
author_facet Paka, Prani
Lieber, Sarah R
Lee, Ruth-Ann
Desai, Chirag S
Dupuis, Robert E
Barritt, Alfred Sidney
author_sort Paka, Prani
collection PubMed
description AIM: To investigate the relationship between post-liver transplantation (LT) glycemic control and LT outcomes. METHODS: A qualitative systematic review on relevant prospective interventions designed to control glucose levels including insulin protocols. Studies investigating an association between glycemic control and post-LT outcomes such as mortality, graft rejection, and infection rate were reviewed. PubMed, EMBASE, and other databases were searched through October 2016. RESULTS: Three thousands, six hundreds and ninety-two patients from 14 studies were included. Higher mortality rate was seen when blood glucose (BG) ≥ 150 mg/dL (P = 0.05). BG ≥ 150 mg/dL also led to higher rates of infection. Higher rates of graft rejection were seen at BG > 200 mg/dL (P < 0.001). Mean BG ≥ 200 mg/dL was associated with more infections (P = 0.002). Nurse-initiated protocols and early screening strategies have shown a reduction in negative post-LT outcomes. CONCLUSION: Hyperglycemia in the perioperative period is associated with poor post-LT outcomes. Only a few prospective studies have designed interventions aimed at managing post-LT hyperglycemia, post-transplant diabetes mellitus (PTDM) and their impact on post-LT outcomes.
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spelling pubmed-60337392018-07-09 Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review Paka, Prani Lieber, Sarah R Lee, Ruth-Ann Desai, Chirag S Dupuis, Robert E Barritt, Alfred Sidney World J Transplant Systematic Reviews AIM: To investigate the relationship between post-liver transplantation (LT) glycemic control and LT outcomes. METHODS: A qualitative systematic review on relevant prospective interventions designed to control glucose levels including insulin protocols. Studies investigating an association between glycemic control and post-LT outcomes such as mortality, graft rejection, and infection rate were reviewed. PubMed, EMBASE, and other databases were searched through October 2016. RESULTS: Three thousands, six hundreds and ninety-two patients from 14 studies were included. Higher mortality rate was seen when blood glucose (BG) ≥ 150 mg/dL (P = 0.05). BG ≥ 150 mg/dL also led to higher rates of infection. Higher rates of graft rejection were seen at BG > 200 mg/dL (P < 0.001). Mean BG ≥ 200 mg/dL was associated with more infections (P = 0.002). Nurse-initiated protocols and early screening strategies have shown a reduction in negative post-LT outcomes. CONCLUSION: Hyperglycemia in the perioperative period is associated with poor post-LT outcomes. Only a few prospective studies have designed interventions aimed at managing post-LT hyperglycemia, post-transplant diabetes mellitus (PTDM) and their impact on post-LT outcomes. Baishideng Publishing Group Inc 2018-06-28 2018-06-28 /pmc/articles/PMC6033739/ /pubmed/29988867 http://dx.doi.org/10.5500/wjt.v8.i3.75 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Systematic Reviews
Paka, Prani
Lieber, Sarah R
Lee, Ruth-Ann
Desai, Chirag S
Dupuis, Robert E
Barritt, Alfred Sidney
Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review
title Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review
title_full Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review
title_fullStr Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review
title_full_unstemmed Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review
title_short Perioperative glucose management and outcomes in liver transplant recipients: A qualitative systematic review
title_sort perioperative glucose management and outcomes in liver transplant recipients: a qualitative systematic review
topic Systematic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033739/
https://www.ncbi.nlm.nih.gov/pubmed/29988867
http://dx.doi.org/10.5500/wjt.v8.i3.75
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