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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2018
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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. |
format | Online Article Text |
id | pubmed-6033739 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
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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