{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:38:33Z","timestamp":1761676713392},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T00:00:00Z","timestamp":1550620800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>Liver transplant centers often establish hemoglobin A1c (HbA1C) criteria for candidates with type 2 diabetes mellitus (T2DM) based on data from other surgical specialties showing worse outcomes in patients with poor glycemic control. However, because of the reduced reliability of HbA1C in cirrhosis, it is unclear whether pretransplant HbA1C values are predictive of postoperative complications in liver recipients. We retrospectively examined the association between preoperative HbA1C and postoperative outcomes in 173 consecutive patients who underwent liver transplantation at the University of Cincinnati Medical Center between August 2012 and March 2015. Demographic correlates of pretransplant HbA1C included age, T2DM, native Model for End\u2010Stage Liver Disease, hemoglobin, serum albumin, and nonalcoholic steatohepatitis as the indication for transplantation. No association was identified between pretransplant HbA1C and most outcome measures, including survival, length of stay, reoperation or readmission rates, rejection, bacteremia, and viremia. Significant correlates of HbA1C in liver recipients with diabetes were posttransplant insulin requirement and anastomotic biliary stricture formation. On multivariate analysis, HbA1C was the sole determinant of biliary strictures, with patients in the highest quartile (HbA1C &gt;7.3%) exhibiting a 4\u2010fold increased risk. Correlation of HbA1C with morning blood glucose levels was much tighter after versus before transplantation. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Preoperative HbA1C is predictive of anastomotic biliary stricture formation and the need for insulin following liver transplantation.<\/jats:p>","DOI":"10.1002\/hep4.1323","type":"journal-article","created":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T22:23:31Z","timestamp":1550701411000},"page":"574-586","source":"Crossref","is-referenced-by-count":7,"title":["Influence of Type 2 Diabetes Mellitus and Preoperative Hemoglobin A1c Levels on Outcomes of Liver Transplantation"],"prefix":"10.1097","volume":"3","author":[{"given":"Meagan","family":"Gray","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,University of Alabama at Birmingham,Birmingham,AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeev","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Digestive Diseases,University of Cincinnati Medical Center,Cincinnati,OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen D.","family":"Zucker","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Endoscopy,Brigham and Women\u2019s Hospital,Boston,MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2019,2,20]]},"reference":[{"key":"hep41323-bib-0001-20240114","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1002\/hep.1840190312","article-title":"Pathogenesis of glucose intolerance and diabetes mellitus in cirrhosis","volume":"19","year":"1994","journal-title":"Hepatology"},{"key":"hep41323-bib-0002-20240114","doi-asserted-by":"crossref","first-page":"G1135","DOI":"10.1152\/ajpgi.00278.2004","article-title":"Contribution of defects in glucose uptake to carbohydrate intolerance in liver cirrhosis: assessment during physiological glucose and insulin concentrations","volume":"288","year":"2005","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"key":"hep41323-bib-0003-20240114","first-page":"1051","article-title":"Glucose tolerance and diabetes in chronic liver disease","volume":"2","year":"1967","journal-title":"Lancet"},{"key":"hep41323-bib-0004-20240114","first-page":"837","article-title":"Cirrhosis and diabetes. 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