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

查看全文 作　　者：Prani [1]Paka;Sarah R [2]Lieber;Ruth-Ann [3]Lee;Chirag S [3]Desai;Robert E [1]Dupuis;Alfred Sidney [2]Barritt 高影响力作者 机构地区：[1]Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina;[2]Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina;[3]Division of Abdominal Transplant, Department of Surgery, University of North Carolina School of Medicine高影响力机构 出　　处：《World Journal of Transplantation》索引2018年第8卷第3期,共9页高影响力期刊 摘　　要：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. Pub Med, 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. 关 键 词：Diabetes LIVER transplant Non-alcoholic STEATOHEPATITIS OUTCOMES Non-alcoholic fatty LIVER disease
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