Ignite Creation Date:
2024-05-06 @ 8:16 PM
Last Modification Date:
2024-10-26 @ 3:24 PM
Study NCT ID:
NCT06320730
Status:
COMPLETED
Last Update Posted:
2024-03-20
First Post:
2024-03-08
Brief Title:
Impact of Glycemic Control After Reperfusion on Acute Kidney Injury in Living Donor Liver Transplantation
Sponsor:
Asan Medical Center
Organization:
Asan Medical Center
Study Overview
Official Title:
Impact of Glycemic Control After Reperfusion on Acute Kidney Injury in Living Donor Liver Transplantation A Propensity Score-matched Analysis
Status:
COMPLETED
Status Verified Date:
2024-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
This retrospective cohort study of patients classified by the blood glucose level after reperfusion in liver transplantation repicient Our object is to investigate whether controlling BG levels within the optimal range during neohepatic phase is associated with a reduction of AKI incidence Furthermore severe AKI chronic kidney disease CKD major adverse cardiac event MACE and mortality were also investigated
Detailed Description:
The detrimental impact of glucose instability including hyper- and hypoglycemia on postoperative outcomes has been well-established in various fields particularly in cardiac surgery and intensive care unit settings Also glucose instability occurs frequently in liver transplantation LT surgery attributed to factors such as insulin resistance surgical stress and onset of gluconeogenesis after reperfusion of the newly transplanted graft Previous reports have demonstrated that hyperglycemia is associated with increased mortality a higher incidence of graft rejection and surgical site infection in LT Alongside hyperglycemia it is also important to consider hypoglycemia given its association with adverse outcomes
Acute kidney injury AKI stands as one of the most common and critical complications following LT impacting extended duration of hospital stay increased morbidity and mortality Although the etiology of AKI after LT is multifactorial perioperative hyper- and hypoglycemia have also been suggested as potential risk factors for postoperative AKI However a recent study only has demonstrated that increased glucose variability rather than hyper-and hypoglycemia alone is associated with postoperative AKI after LT The contradictory results observed to date may be attributed to differences in the definition of hyperglycemia reflecting the challenges in determining the optimal blood glucose BG level in LT In our study the optimal BG level was determined according to the most recently updated and professional guidelines on glycemic control
Identifying the timing for glycemic control during LT is also as crucial as determining the optimal BG level BG levels reach their peak in the neohepatic phase and begin to decrease 3 hours after reperfusion This excessively elevated hyperglycemia is due to glucose influx from the grafted liver in addition to peripheral insulin resistance and gradually decreases after successful LT Therefore maintaining a well-controlled BG level within the optimal range especially during the neohepatic phase may be associated with better outcomes after transplantation
Our object is to investigate whether controlling BG levels within the optimal range during neohepatic phase is associated with a reduction of AKI incidence Furthermore severe AKI chronic kidney disease CKD major adverse cardiac event MACE and mortality were also investigated
Acute kidney injury AKI stands as one of the most common and critical complications following LT impacting extended duration of hospital stay increased morbidity and mortality Although the etiology of AKI after LT is multifactorial perioperative hyper- and hypoglycemia have also been suggested as potential risk factors for postoperative AKI However a recent study only has demonstrated that increased glucose variability rather than hyper-and hypoglycemia alone is associated with postoperative AKI after LT The contradictory results observed to date may be attributed to differences in the definition of hyperglycemia reflecting the challenges in determining the optimal blood glucose BG level in LT In our study the optimal BG level was determined according to the most recently updated and professional guidelines on glycemic control
Identifying the timing for glycemic control during LT is also as crucial as determining the optimal BG level BG levels reach their peak in the neohepatic phase and begin to decrease 3 hours after reperfusion This excessively elevated hyperglycemia is due to glucose influx from the grafted liver in addition to peripheral insulin resistance and gradually decreases after successful LT Therefore maintaining a well-controlled BG level within the optimal range especially during the neohepatic phase may be associated with better outcomes after transplantation
Our object is to investigate whether controlling BG levels within the optimal range during neohepatic phase is associated with a reduction of AKI incidence Furthermore severe AKI chronic kidney disease CKD major adverse cardiac event MACE and mortality were also investigated
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None