The association of intraoperative hyperglycemia and postoperative infectious complications after lung transplantation: a single-center retrospective study.

Purpose: Postoperative infections remain a significant problem in lung transplantation. We explored factors associated with postoperative infection after lung transplantation, including intraoperative hyperglycemia.

Methods: Forty-six lung transplant patients were included in the study. The background of these patients and the relationship between each factor and postoperative infectious complications were retrospectively investigated. In the present study, intraoperative hyperglycemia was defined as a mean intraoperative blood glucose level of ≥ 180 mg/dL.

Results: Nineteen patients were classified into the intraoperative hyperglycemia group. Eighteen patients had postoperative infections, and the intraoperative hyperglycemia group had a higher rate of postoperative infections than the non-hyperglycemia group. A multivariate analysis showed that intraoperative hyperglycemia was independently associated with post-transplantation infection (p < 0.01). The 5-year overall survival rates of the intraoperative hyperglycemia and non-hyperglycemia groups were 59.2% and 75.0%, respectively, whereas those of the post-transplant infection and non-infected groups were 47.7% and 80.0%, respectively, with a trend toward a worse prognosis in the intraoperative hyperglycemia and post-transplant infection groups (p = 0.234 and 0.059, respectively).

Conclusion: Intraoperative hyperglycemia is associated with the development of postoperative infections after lung transplantation. Patients with poor intraoperative blood glucose control may have an increased risk of postoperative infections. Intraoperative blood glucose management is crucial for improving the post-transplant clinical course.