Induction of Artificial Pancreas in Liver Transplant Recipients: Preliminary Experience with an Insightful Message
Hironori Hayashi, Hiroyuki Takamura, Ryosuke Gabata, Isamu Makino, Yoshinao Ohbatake, Shinichi Nakanuma, Tomoharu Miyashita, Hidehiro Tajima, Kazuhiro Hanazaki, Tetsuo Ohta
Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
Ann Transplant 2017; 22:590-597
We investigated the impact of using an artificial pancreas for glycemic control in liver transplant recipients.
MATERIAL AND METHODS: Between January 2014 and December 2016, glycemic control using an artificial pancreas was performed 13 times. The target blood glucose level was set at 80–110 mg/dL. We retrospectively analyzed the clinical course, including achievement rate of the target blood glucose range.
RESULTS: For perioperative glycemic control, an artificial pancreas was used 9 times. The total insulin dose and achievement rate of the target blood glucose level were 113.9±51.4 U and 23.7±15.6%, per 24 h, respectively. Additionally, recipients with infectious complications (n=2) and rejection treated with methylprednisolone pulse therapy (n=2) received glycemic control using an artificial pancreas. The total insulin dose and achievement rate of the target blood glucose level were 156.5±57.5 U and 20.2±20.0% per 24 h, respectively. No hypoglycemia occurred during this period.
CONCLUSIONS: Application of an artificial pancreas for liver transplant recipients was safe, with no hypoglycemia. The results suggest that occurrence of marked insulin resistance in liver transplant recipients should be prevented for better outcomes.
Keywords: Diabetes Mellitus, Insulin Resistance, Liver Transplantation, Postoperative Complications