Model-based estimation of physiological parameters in the reperfusion phase of liver transplantation

In liver transplantation (LT) well defined increase of blood glucose (BG) level can be observed after the revas-cularization of allografted liver, which is followed by a highly variable BG level period. Managing the BG level in the normo-glycemic range would cause a positive effect on the outcomes of the surgery. Model-based approach may lead us to design appropriate glycemic control (GC) method. In this paper we suggest to modify the so called ICING model to describe the dynamics of the BG level during LT. The identified physiological parameters allow the model to follow the characteristic blood glucose dynamics during and after the reperfusion phase of LT as well. The possibility of the measurements of physiological parameters are restricted due to the surgery conditions. The suggested model also let us estimate the rate of the endogenous glucose production and the insulin independent glucose uptake.