Effects of a glucose meal on energy metabolism in patients with cirrhosis before and after liver transplantation

Hypothesis: Liver transplantation results in hepatic denervation. This may produce alterations of liver energy and substrate metabolism, which may con tribute to weight gain after liver transplantation. Design: Prospective clinical study. Setting: Liver transplantation clinics in a university hospital. Patients: Seven nondiabetic patients with cirrhosis were recruited while on a waiting list for liver transplantation. Seven healthy subjects were recr uited as controls. Intervention: Orthotopic liver transplantation. Main Outcome Measures: Evaluation of energy and substrate metabolism after ingestion of a glucose load with indirect calorimetry was performed before, 2 to 6 weeks after, and 5 to 19 months after transplantation. Whole-body g lucose oxidation and storage and glucose-induced thermogenesis were calcula ted. Results: Patients with cirrhosis had modestly elevated resting energy expen diture and normal glucose-induced thermogenesis and postprandial glucose ox idation and storage. These measures remained unchanged after liver transpla ntation despite a significant increase in postprandial glycemia. Patients, however, gained an average of 3 kg of body weight after 5 to 19 months comp ared with their weight before transplantation. Conclusion: Liver denervation secondary to transplantation does not lead to alterations of energy metabolism after ingestion of a glucose load.