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Minerva Anestesiologica 2018 October;84(10):1142-9

DOI: 10.23736/S0375-9393.18.12285-1


language: English

Usefulness of postreperfusion lactate clearance for predicting early graft recovery in liver transplant patients: a single center study

Valter PERILLI 1, Paola ACETO 1 , Teresa SACCO 1, Pierpaolo CIOCCHETTI 1, Domenico PAPANICE 1, Carlo LAI 2, Liliana SOLLAZZI 1

1 Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; 2 Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy

BACKGROUND: The role of postreperfusion lactate clearance in assessing graft function has not yet been investigated. The aim of this study was to examine whether lactate clearance, assessed in the postreperfusion phase, can predict poor graft function in liver transplant patients.
METHODS: Seventy patients undergoing liver transplantation (LT) were enrolled. Standardized anesthesia and intraoperative monitoring were applied. The lactate levels measured immediately after venous reperfusion and six hours later were used to calculate lactate clearance by the following formula: [(reperfusion lactate - 6 h post-reperfusion lactate)/reperfusion lactate] ×100. Student’s t-test was performed to evaluate differences in lactate clearance between patients with good and poor graft function. Logistic regression was used to assess predictors of poor graft function.
RESULTS: Postreperfusion lactate clearance was lower in patients with poor graft function compared to those with good graft function (P=0.0007). Logistic regression showed that postreperfusion lactate clearance may represent an early predictor of poor graft function (area under receiver operating characteristic curve =0.83). A lactate clearance cut-off of 59.7% was found (90% sensitivity, 38.3% specificity).
CONCLUSIONS: Postreperfusion lactate clearance may be useful for the early identification of poor graft function after LT. In patients with lactate clearance <59.7%, it could be useful to search for the underlying cause of poor graft function.

KEY WORDS: Lactates - Reperfusion - Liver transplantation

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