Complications associated with hyperglycemia in liver transplant patients

Abstract

Background: Hyperglycemia is a frequent phenomenon in hospitalized patients that is associated with negative outcomes. It is common in liver transplant patients as a result of stress and is related to immunosuppressant drugs. Although studies are few, a history of diabetes and the presentation of hyperglycemia during liver transplantation have been associated with a higher risk for rejection. Aims: To analyze whether hyperglycemia during the first 48 hours after liver transplantation was associated with a higher risk for infection, rejection, or longer hospital stay. Methods: A retrospective cohort study was conducted on patients above the age of 15 years that received a liver transplant. Hyperglycemia was defined as a value above 140 mg/dl and it was measured in three different manners (as an isolated value, as a mean value, and as a weighted value over time). The relation of hyperglycemia to a risk for acute rejection, infection, or longer hospital stay was evaluated. Results: Some form of hyperglycemia was present in 94% of the patients during the first 48 post-transplantation hours, regardless of its definition. There was no increased risk for rejection (OR: 1.49; 95% CI: 0.55-4.05), infection (OR: 0.62; 95% CI: 0.16-2.25), or longer hospital stay between the patients that presented with hyperglycemia and those that did not. Conclusions: Hyperglycemia during the first 48 hours after transplantation appeared to be an expected phenomenon in the majority of patients and was not associated with a greater risk for rejection or infection and it had no impact on the duration of hospital stay.

Keywords

• Liver transplant
• Graft rejection
• Hyperglycemia