Koh Hwa-Hee, Lee Minyoung, Kang Minyu, Yim Seung Hyuk, Choi Mun Chae, Min Eun-Ki, Lee Jae Geun, Joo Dong Jin, Kim Myoung Soo, Lee Jae Seung, Kim Deok-Gie
Department of Surgery, Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, South Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Sci Rep. 2025 Jan 6;15(1):951. doi: 10.1038/s41598-024-80604-x.
Several donor-specific factors influence the functional recovery and long-term outcomes of liver grafts. This study investigated the association between donor fasting glucose (DFG) and recipient outcomes after living donor liver transplantation (LDLT) in 950 cases at a single center. Patients were divided into two groups: low-DFG (< 85 mg/dL, n = 120) and control (≥ 85 mg/dL, n = 830). The five-year graft survival rate was significantly lower in the low-DFG group (71.5%) compared to the control group (80.0%) (P = 0.02). Multivariable Cox regression analysis showed that low DFG was independently associated with graft loss (hazard ratio 1.72, 95% CI 1.15-2.56, P = 0.008). In propensity score-matched groups, the low-DFG group also had lower survival rates (71% vs. 83.1%, P = 0.004). The presence of additional risk factors, such as low graft-to-recipient weight ratio, older donor age, and longer cold ischemic time, further reduced graft survival in the low-DFG group. A DFG level < 85 mg/dL is associated with higher risk of graft failure after LDLT, especially when combined with other risk factors. Low DFG should be considered a prognostic marker in LDLT planning, with potential to improve patient outcomes as further research clarifies the underlying pathophysiological mechanisms.
几种供体特异性因素会影响肝移植移植物的功能恢复和长期预后。本研究调查了单中心950例活体肝移植（LDLT）受者中供体空腹血糖（DFG）与受者预后之间的关联。患者被分为两组：低DFG组（<85mg/dL，n = 120）和对照组（≥85mg/dL，n = 830）。低DFG组的五年移植物存活率（71.5%）显著低于对照组（80.0%）（P = 0.02）。多变量Cox回归分析显示，低DFG与移植物丢失独立相关（风险比1.72，95%CI 1.15 - 2.56，P = 0.008）。在倾向评分匹配组中，低DFG组的存活率也较低（71%对83.1%，P = 0.004）。存在其他风险因素，如低移植物与受者体重比、供体年龄较大和冷缺血时间较长，会进一步降低低DFG组的移植物存活率。DFG水平<85mg/dL与LDLT后移植物失败的较高风险相关，尤其是与其他风险因素合并存在时。在LDLT规划中，低DFG应被视为一种预后标志物，随着进一步研究阐明潜在的病理生理机制，有可能改善患者预后。
