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ORIGINAL ARTICLE
Year : 2019  |  Volume : 23  |  Issue : 5  |  Page : 570-574

Preoperative glycated haemoglobin level and postoperative morbidity and mortality in patients scheduled for liver transplant


1 Department of Anaesthesiology, Institute of Liver and Biliary Sciences, New Delhi, India
2 Dharamshila Narayana Superspeciality Hospital, New Delhi, India
3 Department of Trauma and Emergency (Anaesthesiology), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
4 Statistician, Institute of Liver and Biliary Sciences, New Delhi, India
5 Departments of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
6 Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
7 Department of Pediatrics (Endocrinology), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Correspondence Address:
Ankur Sharma
Department of Trauma and Emergency (Anesthesiology), AIIMS, Jodhpur - 342 008, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijem.IJEM_208_19

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Background: There is high prevalence of diabetes mellitus in patients of end stage liver disease and it has been implicated for complications in post-transplant patients. Glycated hemoglobin is now targeted as a modifiable preoperative risk factors for postoperative complications. Data describing the course and severity of postoperative liver transplant complication and their relation with pre-operative glycated hemoglobin level is sparse. In this study, we looked for co-relation between the preoperative HbA1c level and post-operative mortality and morbidity in patients scheduled for liver transplant. Materials and Methods: Retrospective data in 400 adult patients operated for liver transplant were retrieved. After exclusion, data were analyzed for 224 patients. Patients were divided into two groups on the basis of glycated hemoglobin levels (Group 1 (HbA1C ≥6.5) and Group 2 (HbA1C <6.5)). Results: Glycated hemoglobin levels were not associated with postoperative death during stay in intensive care unit, incidence of postoperative cardiovascular, renal, and central nervous complications. No difference was seen between 2 groups for need for renal replacement therapy, incidence of infections, rejection, need for re-exploration surgery and duration of intensive care unit and hospital stay. Glycated hemoglobin cannot predict 30 day survival (Area under curve {AUC} = 0.629, P value 0.05). Conclusion: Preoperative glycated hemoglobin level is not associated with postoperative morbidity and mortality in patients scheduled for liver transplant. Trial Registration Number: CTRI/2018/04/012966.


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