Trial reportHepatology international2025
Preoperative carbohydrate loading reduces perioperative insulin resistance and hastens functional recovery of remnant liver after living donor hepatectomy: An open-label randomized controlled trial.
Trial report in Hepatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 8 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Preoperative Carbohydrate Loading on Post-operative Insulin Resistance After Donor Hepatectomy: A Randomized Controlled Trial
Effect of Preoperative Carbohydrate Loading on Perioperative Serum Lactate Levels in Patients Undergoing Donor Hepatectomy: A Randomized Controlled Trial
Who cites it
8 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Preoperative oral carbohydrate administration in adult elective surgery: protocol heterogeneity, regional practice patterns and evidence gaps-a scoping review.Frontiers in nutrition · 2026Pooled it
- Preoperative carbohydrate loading: evolution, trends, and future directions.Frontiers in nutrition · 2026Pooled it
- Effects of macro- and micronutrient intake on bone mineral density, osteoporotic fracture risk, inflammation, and functional rehabilitation outcomes in orthopedic patients: a systematic review and meta-analysis.Frontiers in nutrition · 2026Pooled it
- The Effect of Preoperative Oral Carbohydrate Loading on Insulin Resistance in Adult Patients Undergoing On-Pump Cardiac Surgery: A Randomized Controlled Trial.Annals of cardiac anaesthesia · 2026Trial
- Effects of perioperative probiotic supplementation on postoperative gastrointestinal recovery in elderly hip fracture patients: a randomized controlled trial.BMC anesthesiology · 2026Trial
- Abdominal Organ Transplantation: Noteworthy Literature in 2025.Seminars in cardiothoracic and vascular anesthesia · 2026Review
- Article
- Evidence summary on perioperative blood glucose management in liver cancer patients.Frontiers in oncology · 2026Review
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed to assess the effect of preoperative carbohydrate (CHO) loading on perioperative insulin resistance (PIR) and outcomes after live donor hepatectomy. The primary objective of the trial was to compare PIR on postoperative day (POD) 2 between preoperative oral carbohydrate (CHO) loading and overnight fasting groups. The secondary objectives were to compare the functional recovery of the remnant liver, incidence of postoperative nausea and vomiting (PONV) up to 72 h after surgery, inflammatory markers, and length of hospital stay (LOS) between both groups.
backgroundPreoperative fasting increases perioperative insulin resistance (PIR). Insulin resistance has deleterious effects on liver regeneration following partial hepatectomy.
methodsSingle-center, open-label, randomized controlled trial. After exclusion, 70 donors were recruited (35 from each group). Donors in the intervention arm received 50 g of maltodextrin at 10 PM the night before surgery and 25 g of maltodextrin 2 h before anesthesia induction on the day of surgery, whereas those in the control arm followed a minimum of 6 h of overnight fasting. The PIR was assessed using the Homeostatic Model for Assessment of Insulin Resistance (HOMA-IR).
resultsBaseline and intraoperative parameters were comparable between the two groups. CHO loading provided better postoperative glycemic control (p < 0.01) and reduced PIR by > 50% (p < 0.01) compared to preoperative fasting. Although postoperative complications, inflammatory markers, and LOS were comparable between the groups, there was a significant attenuation of postoperative nausea (p = 0.01) and vomiting (p = 0.013) with early soft diet tolerance (p = 0.002) in the CHO group. In addition, preoperative carbohydrate loading accelerated functional recovery of the remnant liver, with earlier normalization of serum bilirubin levels (p = 0.002).
conclusionCHO supplementation is safe and effective in shortening preoperative fasting during donor hepatectomy without significant postoperative risks. It can be considered a standard of care in donor surgery ERAS (Enhanced Recovery After Surgery) protocols for live donor liver transplantations. REGISTRATION NUMBER: NCT05293444 ( www. CLINICALTRIALS: gov ).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.